CMS - Final Rule to Deny or Revoke the Enrollment of Entities that Pose an Integrity Risk to Medicare

by  Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
December 4th, 2014

On December 3, 2014, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that will improve CMS’ ability to deny or revoke the enrollment of entities and individuals that pose a program integrity risk to Medicare.

This fact sheet summarizes CMS’ regulatory additions and changes.

SUMMARY OF THE PROVIDER ENROLLMENT PROVISIONS

Provider enrollment is the gateway that allows health care providers to bill for services provided to Medicare beneficiaries. CMS routinely evaluates its provider enrollment policies, and has implemented new safeguards as a result of provisions in the Affordable Care Act. In the February 2011 final screening rule (76 FR 5862), CMS revised its enrollment policy in order to increase the integrity of the Medicare program. CMS is now finalizing a number of additional provider enrollment provisions, including the following:

References:

CMS - Final Rule to Deny or Revoke the Enrollment of Entities that Pose an Integrity Risk to Medicare. (2014, December 4). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/cms-final-rule-to-deny-or-revoke-the-enrollment-of-entities-that-pose-a-integrity-risk-to-medicare-2446.html

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