(Feb. 27, 2026) – The Centers for Medicare and Medicaid Services is seeking comments to assist them in developing regulations and process changes in their attempts to reduce fraud and to uncover suspicious healthcare practices. They released a Request for Information: Comprehensive Regulations to Uncover Suspicious Healthcare, in anticipation of a proposed rule called Comprehensive Regulations to Uncover Suspicious Healthcare, or CRUSH. Prior to publishment of the Request for Information on Feb. 27, CMS offered a preview of the document. They are seeking comments from hospitals and providers on a broad array of topics, as listed below:
Modification of Program Integrity Requirements:
- Enhanced Identity Proofing and Ownership Requirements
- Preclusion List and Medicare Advantage Enrollment Requirements
- Reducing Medicare Fraud related to Lab Tests (esp. Genetic and Molecular)
- Reducing Risks from Durable Medical Equipment, Prosthetics, Orthotics and Suppliers in Medicare Advantage
- Reducing Fraudulent Medicare Parts A and B Claims Submission
- Artificial Intelligence in Medicare Advantage Coding Oversight and Hospital Billing
- Beneficiary Solicitation and Contact
- Surety Bonds
- Medicaid and CHIP
- Federally Facilitated Exchanges and State-Based Exchanges
Please review the Request for Information: Comprehensive Regulations to Uncover Suspicious Healthcare and provide comments in any of these areas and help guide CMS in development of future proposed rulemaking. Please share questions and comments with Larry Van Der Wege at lvanderwege@KHA-net.org or Jaron Caffrey at jcaffrey@KHA-net.org.
--Larry Van Der Wege