The Centers for Medicare & Medicaid Services today issued a final rule with comment period implementing additional program integrity requirements for health care providers and suppliers who participate in certain federal health insurance programs. Specifically, the final rule will require Medicare, Medicaid and Children's Health Insurance Program providers and suppliers to disclose certain current and previous affiliations with other providers and suppliers that have: uncollected debt; been or are subject to a payment suspension under a federal health care program; been or are excluded by the Department of Health and Human Services’ Office of Inspector General from Medicare, Medicaid or CHIP; or had their Medicare, Medicaid or CHIP billing privileges denied or revoked. It provides CMS with additional authority to deny or revoke a provider's or supplier's Medicare enrollment in specified circumstances. The rule gives CMS the ability to prevent applicants from enrolling in the program for up to three years if a provider or supplier is found to have submitted false or misleading information in its initial enrollment application. In addition, the rule allows CMS to block providers and suppliers who are revoked from re-entering the Medicare program for up to 10 years. Previously, revoked providers could be prevented from re-enrolling for only up to three years. AHA provided feedback related to a number of these provisions in 2016 when CMS issued a proposed rule. The final rule is effective Nov. 4.

Related News Articles

Headline
House Democratic leaders today released the Lower Drug Costs Now Act, a bill that would make a series of changes to the Medicare program in an effort to lower…
Headline
The Centers for Medicare…
Headline
Rebates reduced the growth in Medicare Part D spending for brand-name drugs between 2011 and 2015, but spending for brand-name drugs with rebates still grew by…
Headline
The AHA and five other hospital groups today filed a
Headline
The AHA today urged the Centers for Medicare…
Headline
The rule would force millions of immigrants “to choose between accepting public services and accepting a green card … an impossible choice,” the brief states.