WASHINGTON, D.C. – Today, Senators Rick Scott, John Cornyn, Chris Van Hollen and Catherine Cortez Masto introduced the Medical License Verification Act to prevent fraud in the healthcare system by requiring the Centers for Medicare & Medicaid Services (CMS) to verify that an applicant’s medical license is valid and in good standing prior to issuing them a National Provider Identifier (NPI) number, which is required by healthcare providers to bill for insurance.
Under current law, CMS issues NPI numbers without verification of the licensure information submitted, which allows non-physicians to obtain NPI numbers and opens up the possibility that they may fraudulently bill commercial health insurance.
Senator Rick Scott said, “Under our current system, loopholes exist that have allowed non-doctors to fraudulently bill health insurance companies to the tune of millions of dollars, which ultimately gets passed along to the consumer. This is unfair and it has to stop. The Medical License Verification Act is a small and commonsense step to address this weakness and prevent bad actors from defrauding families.”
Senator Cornyn said, “Patients and taxpayers deserve assurance that non-physicians aren’t billing health insurance companies fraudulently to line their own pockets. This legislation would ensure medical providers are properly licensed before they are able to bill insurance for the care they provide.”
Senator Van Hollen said, “Preventing fraud in our healthcare system protects patients and ultimately lowers costs across the board. This legislation will help crack down on unlicensed providers, and in turn, reduce fraudulent billing. I’m proud to introduce this bipartisan, common-sense bill, and I will continue working to reduce healthcare costs for Americans.”
Senator Cortez Masto said, “This legislation will help keep bad actors from defrauding insurers, patients and the taxpayers who support Medicare and Medicaid programs. Commercial health care plans cover some of our most vulnerable populations, and we should be doing all we can to ensure that these plans continue to be run effectively.”