AHCA/NCAL submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to a Request for Information (RFI) on the Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) initiative [RIN 0938-AV97]. The CRUSH RFI seeks stakeholder feedback on potential policy approaches to strengthen detection, prevention, and enforcement of fraud-waste, and abuse (FWA) across federal health care programs.
Areas of focus include provider screening, ownership verification, identity proofing, and oversight. The request also reflects broader CMS priorities related to FWA, including DMEPOS supplier oversight, AI-assisted coding risks, and beneficiary protection measures.
Key AHCA/NCAL recommendations from this response include:
- Target fraud-prevention approaches, including AI-based program integrity tools, toward high-risk actors rather than applying broad,…
Treat every unsolicited “urgent” communication from a bank or government agency as a potential “Vishing” or “Smishing” attack, regardless of how official the branding or phone number appears.