decisionhealth Newsletters, Part B News - 2016 Issue 3 (March)
Proposed enrollment rule will have practices rethinking relationships
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Article Overview
This piece explains a CMS proposed rule on provider enrollment integrity and why it could matter to practices with complex ownership, management, or referral relationships. It is aimed at providers, practice leaders, enrollment staff, and compliance professionals who need to understand the broad categories of information CMS would review, the programs affected, and the rulemaking timeline. The article also notes the associated federal reference and public comment process.
Why This Topic Matters
The proposal could affect whether a practice can enroll, remain enrolled, or revalidate across federal health care programs, so organizations with multiple business relationships need to understand the scope of the rule and monitor related compliance obligations.
Article Sections
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Enrollment
Overview of the proposed CMS enrollment changes and the types of affiliations and relationships that may be reviewed during enrollment or revalidation.
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Resource
Reference to the federal rulemaking document associated with the proposal.
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Editor’s note
Information about a related enrollment workshop and where to obtain additional event details.
What You Will Learn
- Which broad enrollment topics are addressed by the proposed CMS rule
- What categories of affiliations and program integrity issues are discussed
- How the article frames the rulemaking timeline and public comment process
- Which federal programs are implicated by the proposal
Who Should Read This
- Physician practices
- Practice administrators
- Enrollment specialists
- Compliance officers
- Billing and revenue cycle staff
- Health care attorneys
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