Date Posted: Tuesday, July 196, 2025

 

Announced in February of this year (2025), the Centers for Medicare and Medicaid Services (CMS) and the new Department of Government Efficiency (DOGE) collaboration aims to identify inefficiencies, fraud, and outdated systems in Medicare's vast billing and contracting infrastructure. Sounds hopeful, but what does this mean for the everyday medical practitioner and their practice's financial health?

 

Let's break it down.

 

What's Happening With the CMS and DOGE Collaboration?

 

CMS, the federal agency managing Medicare and Medicaid, shared news about teaming up with DOGE to enhance resource use. Two experienced CMS leaders—one handling policies and the other focusing on daily operations—are leading this effort.

 

DOGE now has “read-only” access to CMS's extensive digital systems. Their job is to observe CMS payment reforms and contracts. They can't change anything in the data, but they are studying billions in yearly payments to catch fraud, overpayments, or delays.

 

This initiative aligns with President Trump's broader federal efficiency mission, positioning CMS as a key focus due to its size and influence.

 

Key Areas Under Review

 

The partnership is zeroing in on three main aspects:

 

1. Medicare Payment Processes: DOGE is reviewing how Medicare handles claim submissions. They are verifying that providers are being paid accurately and are aiming to avoid systemic errors.

 

2. Oversight of Vendors and Contracts: They are looking at connections with outside contractors to find wasted money or cases where work is not adequately completed or within compliance.

 

3. Systemic Bottlenecks: Problems like slow reimbursement or claims being rejected stand out as warning signs. CMS and DOGE want to figure these out and fix them.

 

These checks might lead to better systems for practices. But in the meantime, they might also mean stricter oversight and extra reporting work.

 

Concerns and Considerations

 

It makes sense that privacy advocates have voiced concerns. Letting any outside group, even one as well-known as DOGE, access CMS systems raises worries about patient information staying secure.

 

CMS assures its stakeholders that DOGE can view data, but it cannot change records or interact with live patient details. Still, even with something as minimal as passive oversight, managing a clinic or handling claims might feel tricky.

 

This is where CBS Medical Billing and Consulting steps in. CBS takes complicated tasks and makes them simpler. Practices run with ease even during times when regulations feel tougher to navigate. Keeping you informed and prepared—on both sides of the coin—is part of CBS's process. 

 

How the CMS-DOGE Collaboration Might Impact Medical Billing in 2025 

 

On the upside, CMS and DOGE working closely together could lead to fewer instances of fraud, embezzlement, and other malicious actions that ran rampant in the DGE industry. On the downside, government controls tend to cripple creativity and autonomy, making it especially difficult for smaller, mom-and-pop medical practices, to be able to run their business in alignment with their values and philosophy rather than catering to rules and regulations. 

 

If you're a medical practice dealing with Medicare claims, here's what this new collaboration could mean for you:

 

• More Frequent Audits: DOGE's focus on fraud detection might lead to more audits. CBS supports its partners with tight claims systems that make audits feel like routine tasks rather than emergencies.

 

• Compliance Rules May Get Stricter: New compliance guidelines could change claim codes and how submissions are made. CBS tracks these changes and turns them into clear steps that clients can follow.

 

• Payment Delays Could Happen: Though there are no official announcements, deep reviews often lead to slower responses. Still, CBS's average of 17 days for reimbursements helps reduce the sting from delayed CMS payments.

 

• Accuracy Will Matter More: Now more than ever, claims need to be error-free. CBS's claim scrubbing service helps make sure every submission can handle even the closest examination.

 

CBS Recommendations for Providers Right Now

 

CBS suggests that caregivers and office managers take these active measures:

 

• Make Your Practice Audit-Ready: CBS offers free evaluations to analyze your practice, including examining your billing setup, confirming compliance, and finding weak points before regulators notice them.

 

• Revise Your Contracts: Look over your Medicare contracts. CBS can assist with contract negotiation to keep you aligned with the latest CMS guidelines.

 

• Train and Equip Your Team: Your billing team might not be sure what to get ready. That's fine. CBS provides specialized staff training to keep your practice running and following all rules.

 

• Work With Experts: You didn't start your clinic to deal with rejected claims. CBS can take care of billing so you can focus on what matters—caring for patients.

 

Why CBS Medical Billing Is the Right Partner Right Now

 

CBS is not just another billing company; CBS offers:

 

• Reliable Results: Most CBS clients get their first payments within 17 days after submitting clean claims.
  
  
• Dedicated Assistance: CBS gives every partner a Client Success Manager who helps them from onboarding to navigating regulations.
  
  
• Relentless Advocacy: CBS's denial management team works hard on every claim, no matter if it's $1,000 or $30,000. The effort stays the same.
  
  
• True Partnership: CBS succeeds when CBS's partners succeed. CBS doesn't just treat this as a business but as a shared goal for success.

 

One thing stands out—CBS has already helped medical practices bring back over $200 million in revenue. And this is the beginning.

 

Final Thoughts on CMS and DOGE

 

The CMS and DOGE partnership could mark the start of big changes in federal healthcare oversight. But what's problematic for some is often an opportunity for those prepared. 

 

For CBS clients, this time of regulatory shifting doesn't need to spark fear or confusion. CBS Medical Billing and Consulting uses regulatory changes as opportunities for growth. CBS helps practices stay compliant and profitable while ensuring they stay focused on what matters most—taking care of patients.

 

Worried about compliance or upcoming changes in systems? Reach out and learn about CBS Medical Billing Services now to get a partner for the times to come. 

 

Erin Cammarata, Founder and Principal, CBS Medical Billing and Consulting Services, has dedicated her career to advancing the health of medical practices like yours.

 

Erin Cammarata founded CBS Medical Billing and Consulting Services as the missing piece for medical practices throughout the U.S. As a successful educator, trainer, author, and entrepreneur, Erin is highly sought by industry professionals and individual clients for her expertise, consultation, and training services.

 

https://www.cbsmedicalbilling.com/