CHA News Article

CMS Issues Proposed Rule on Enhancements to Provider Enrollment

The Centers for Medicare & Medicaid Services (CMS) has issued the attached rule proposing new regulations implementing additional provider enrollment provisions of the Affordable Care Act. The regulations attempt to ensure that entities and individuals who pose risks to the Medicare program and its beneficiaries are kept out of or removed from Medicare for extended periods. These enhancements, if finalized, would allow CMS to take action to remove or prevent the enrollment of health care providers and suppliers that attempt to circumvent Medicare’s enrollment requirements through name and identity changes, as well as through elaborate inter-provider relationships. The proposed provisions will also address other program integrity issues and vulnerabilities, such as cases in which providers and suppliers avoid paying their Medicare debts by reenrolling as a different entity. Comments on the proposed rule are due May 1.