In true government fashion, CMS probably spent a year and a few million in consulting fees to arrive at the acronym CRUSH - Comprehensive Regulations to Uncover Suspicious Healthcare. There were focus groups. There were branding decks. Somebody's nephew who works in marketing got a contract. And after all that time and money, what does CRUSH actually do? It's a Request for Information.
That's government-speak for "we don't know what to do so we're asking you." The agency with the data, the budget, the authority, and 28 years of OIG reports gathering dust is crowdsourcing fraud solutions from the general public. We love the chutzpah and the honesty of asking everyone else to do your job!
OK chevra, baby steps. We believe in them. CMS had every Medicaid billing record in America. State tax authorities had every provider's income return. For decades these two agencies existed in the same government, on the same taxpayer dime, and never once thought to compare notes. A provider could bill Medicaid $5 million and report $800K to the state and nobody blinked because nobody was looking.
But in 2025, CMS bravely - courageously - launched a partnership with 28 states to cross-reference the data. Twenty-eight. I think I can, I think I can, I think I can. Only 22 states to go. The technology powering this revolution? A phone call. Maybe a shared spreadsheet. Give them time. They're learning.