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CMS Advises Changes to Provider and Supplier Enrollment Rules

Posted on Tuesday, March 8, 2016 8:55 AM

CMS has proposed a rule to implement additional provider enrollment regulations directed at providers and suppliers that challenge to circumvent Medicare’s enrollment requirements. For the Disclosure of Affiliations, CMS would require health care providers and suppliers to report affiliations with entities and individuals that:

  • Have uncollected debt to Medicare, Medicaid, or CHIP
  • Have been or are subject to a payment suspension under a federal health care program or subject to an Office of Inspector General (OIG) exclusion
  • Have had their Medicare, Medicaid, or CHIP enrollment denied or revoked

The health care providers or suppliers could be denied Medicare, Medicaid, or CHIP enrollment if CMS figures out that the relationship poses an unnecessary risk of fraud, waste, or abuse. For the full article, click here.


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