# 2026-03968: CMS Wants Ideas to CRUSH Sneaky Healthcare Scams in Medicare 2026-03968, Request for Information (RFI) Related to Comprehensive Regulations To Uncover Suspicious Healthcare (CRUSH), is a Federal Register proposed rule from Health and Human Services Department, Centers for Medicare & Medicaid Services published 2026-02-27, effective To be assured consideration, comments must be received at one of the addresses provided below, by March 30, 2026.; PRIA reads it as touching household money (as of 2026-06-11). - Canonical: https://policyrisk.com/federal-register/2026-03968 - As of: 2026-06-11 - Plain-text twin of the page above; the HTML and this file carry the same facts. ## Facts - Document number: 2026-03968 - Title: Request for Information (RFI) Related to Comprehensive Regulations To Uncover Suspicious Healthcare (CRUSH) - Type: Proposed Rule - Agencies: Health and Human Services Department; Centers for Medicare & Medicaid Services - Citation: 91 FR 9803 - Published: 2026-02-27 - Effective: To be assured consideration, comments must be received at one of the addresses provided below, by March 30, 2026. - Comments close: not stated - Significant: no - Touches household money: yes - Regulation identifier numbers: 0938-AV97 - Last updated: 2026-06-11 ## In one line CMS Wants Ideas to CRUSH Sneaky Healthcare Scams in Medicare ## Summary CMS wants your ideas to help stop healthcare fraud and protect taxpayer money. They’re thinking about new rules to catch sneaky scams in Medicare and Medicaid, and they need feedback by March 30, 2026. If you’re involved in healthcare or just care about fair spending, this could affect you! ## Abstract This request for information (RFI) solicits stakeholder feedback on potential regulatory changes that might be included in a potential upcoming CRUSH proposed rule, as well as other programmatic changes that could be implemented to make CMS more effective in crushing fraud to protect taxpayer dollars and the Americans we serve. ## Effects PRIA read - Citizenship/Residency for Owners: cost, high. CMS is asking about a possible rule that would require U.S. citizenship or legal permanent residency for any individual with a 5 percent or greater ownership or control interest in a Medicare-enrolled provider or supplier. This proposal would directly affect Medicare-enrolled businesses that have n… - Expand Fingerprinting & Background Checks: cost, medium. CMS is considering expanding fingerprinting and criminal background check requirements beyond current rules that apply to 5 percent or greater owners in high‑risk organizations (42 CFR 424.518). Possible expansions could cover managing employees, owners with less than 5 percent interest, or other a… - MA/Part D Payment Suspension Authority: cost, medium. CMS notes it currently lacks affirmative regulatory authority to require Medicare Advantage organizations and Part D sponsors to suspend payments to providers and suppliers operating exclusively in Part C or Part D. CMS is asking whether it should create regulatory requirements allowing (or requiri… - Preclusion List and MA Enrollment Rule: cost, medium. CMS is soliciting feedback on strengthening the preclusion list because providers revoked from Traditional Medicare can sometimes shift billing to Medicare Advantage plans. CMS is asking whether MA billing should require enrollment in Traditional Medicare (Fee‑for‑Service) as a condition of billing… - Lab Tests: MolDX Registration & Oversight: mixed, medium. CMS highlights that Medicare Part B lab test spending was $8.4 billion in 2024 and that genetic tests were 5 percent of tests but accounted for 43 percent ($3.6 billion) of Part B lab spending. CMS is requesting feedback on new authorities and whether requiring laboratories to register in the MolDX… - DMEPOS Supplier Accreditation Requirement: mixed, medium. CMS is seeking feedback on steps to address fraud by non‑participating DMEPOS suppliers billing Medicare Advantage plans, noting that Medicare payments for DMEPOS top more than $7 billion in Traditional Medicare alone. CMS asks whether MA organizations should require DMEPOS suppliers to be accredit… - Shorten Medicare Claim Filing Deadline: cost, medium. CMS is asking about reducing the Medicare Parts A and B claim filing deadline for high‑risk items and services from the current 1-calendar‑year deadline to a 90 to 180 calendar day deadline. CMS notes this is intended to reduce back‑billing that can obscure fraudulent claims. - Ban Unsolicited Outreach Beyond Phone: benefit, medium. CMS is considering expanding the existing prohibition on unsolicited telephone contact by DMEPOS suppliers (section 1834(a)(17) of the Act and 42 CFR 424.57(c)(11)) to other forms of communication such as email, text message, and social media, and possibly expanding prohibited solicitation to other… - Increase & Expand Surety Bonds: cost, medium. CMS is requesting feedback on strengthening the existing DMEPOS surety bond requirement, which currently requires a bond of at least $50,000, including options to increase the bond amount, require bonds for additional provider/supplier types, and strengthen surety company accountability. CMS also a… - Stronger Medicaid/CHIP Integrity Tools: mixed, medium. CMS is seeking feedback on expanding regulatory authority and tools to reduce fraud, waste, and abuse in Medicaid and CHIP, including whether states should require more frequent revalidation of high‑risk providers than the current 5‑year schedule. CMS is exploring technologies and reporting that st… - Strengthen Exchange Agent & Broker Oversight: benefit, medium. CMS is asking how to strengthen program integrity in the Federally Facilitated Exchange (FFE) and State‑Based Exchanges (SBEs), including improved oversight, vetting, and accountability for agents, brokers, web‑brokers, and direct enrollment entities, and better income verification to prevent fraud… - Use of AI for Coding & Billing Oversight: benefit, low. CMS is seeking input on using artificial intelligence (AI), including machine learning and commercial off‑the‑shelf products, to assist human coders with large volumes of records, improve coding accuracy, and increase hospital billing efficiency. CMS asks about features, display of AI recommendatio… ## Related documents - [2026-20281](https://policyrisk.com/federal-register/2026-20281): Global Benchmark for Efficient Drug Pricing (GLOBE) Model, 2026-10-02 - [2026-20131](https://policyrisk.com/federal-register/2026-20131): Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2027 and Updates to the IRF Quality…, 2026-10-01 - [2026-19959](https://policyrisk.com/federal-register/2026-19959): Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Prog…, 2026-09-30 - [2026-20067](https://policyrisk.com/federal-register/2026-20067): Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements; Correction, 2026-09-30 - [2026-19946](https://policyrisk.com/federal-register/2026-19946): Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospectiv…, 2026-09-29 - [2026-15686](https://policyrisk.com/federal-register/2026-15686): Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements, 2026-08-03 ## Sources - [2026-03968 on federalregister.gov](https://www.federalregister.gov/documents/2026/02/27/2026-03968/request-for-information-rfi-related-to-comprehensive-regulations-to-uncover-suspicious-healthcare) - [2026-03968 as published (PDF)](https://www.govinfo.gov/content/pkg/FR-2026-02-27/pdf/2026-03968.pdf) ## Related - [Previous: 2026-03962, Employee or Independent Contractor Status Under the Fair Labor Standards Act, F…](https://policyrisk.com/federal-register/2026-03962) - [Next: 2026-03993, Approval of the 2023 Edition of the American Society of Mechanical Engineers Bo…](https://policyrisk.com/federal-register/2026-03993) - [All Federal Register documents](https://policyrisk.com/federal-register) Source: PRIA, https://policyrisk.com/federal-register/2026-03968 (as of 2026-06-11).