(Feb. 27, 2026) – The Centers for Medicare & Medicaid Services seeks comments to help develop regulations and process changes to reduce fraud and uncover suspicious health care practices. CMS released a request for information titled Comprehensive Regulations to Uncover Suspicious Healthcare, in anticipation of a proposed rule called Comprehensive Regulations to Uncover Suspicious Healthcare or CRUSH. Prior to the publication of the request for information on Feb. 27, CMS offered a preview of the document. CMS seeks 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 Children's Health Insurance Program
- Federally Facilitated Exchanges and State-Based Exchanges
Please review the Request for Information: Comprehensive Regulations to Uncover Suspicious Healthcare and provide comments on any of these areas and to help guide CMS in the 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