Introduction

The Centers for Medicare & Medicaid Services has signaled that new program-integrity initiatives may be on the horizon. In a February 27, 2026 Request for Information (CMS–6098–NC), CMS is seeking stakeholder input. CMS is considering ways to strengthen its ability to detect fraud, suspend suspicious payments, and enhance provider oversight across federal health programs.

The RFI is part of a broader initiative called Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH). This initiative is aimed at improving fraud detection and preventing improper payments in Medicare, Medicaid, CHIP, and Marketplace programs.

Key Highlights from the CMS Request for Information

Strengthening Program Integrity Tools

CMS is evaluating whether its existing authorities are sufficient to combat fraud and improper payments. The agency is seeking feedback on possible enhancements to enforcement tools such as audits, medical record reviews, and claim monitoring.

Enhanced Provider Enrollment Oversight

The RFI asks stakeholders whether additional safeguards should be implemented to strengthen provider screening, enrollment, and monitoring to prevent fraudulent entities from entering federal healthcare programs.

Payment Safeguards and Investigations

CMS is also considering whether policies governing payment suspensions and investigations should be revised to allow the agency to identify and respond to suspicious billing patterns earlier.

Expanded Use of Data Analytics

Another area of interest is how data analytics and advanced technologies could help CMS detect unusual billing patterns or fraud schemes before improper payments occur.

Why This Matters for Healthcare Providers

Although CMS–6098–NC does not establish new regulations, it signals that the agency may pursue future rulemaking to expand program-integrity authorities. Potential changes could affect provider enrollment requirements, billing oversight, claims review processes, and payment safeguards.

Healthcare organizations should therefore monitor this initiative closely, particularly compliance officers, financial leaders, and executives responsible for regulatory oversight.

Bottom Line

Requests for Information often serve as the first step toward future rulemaking. By seeking stakeholder input through CMS–6098–NC, the Centers for Medicare & Medicaid Services is signaling increased attention to fraud prevention and program integrity across federal healthcare programs. Any resulting regulatory changes could have significant implications for providers participating in Medicare, Medicaid, and other federal health programs.

Do not be surprised if financial and operational audits become a normal routine activity once again in the near future. These were common pre-PPS, and may become common again under this initiative.