Eli's Hospice Insider
CMS Will Use New Criteria To Deny, Revoke Enrollment
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Plus: Your prior Medicare debt history will count against you.
In addition to the revocation authority under the “patterns or practices of abusive billing” standard, the Centers for Medicare & Medicaid Services finalized two other provisions in its new anti-fraud rule issued Dec. 3:
1. The ability to deny enrollment to providers, suppliers and owners affiliated with any entity that has unpaid Medicare debt. “This will prevent people and entities that have incurred substantial Medicare debts from exiting the program and then attempting to re-enroll as a new business to avoid repayment of the outstanding Medicare debt,” CMS notes in a release about the rule.
2. The ability to deny or revoke the enrollment of a provider or supplier if a managing employee has been convicted of a felony offense that CMS determines to be detrimental to Medicare beneficiaries. “Recently implemented background checks will provide CMS with more information about felony convictions for high-risk providers or suppliers,” the agency touts.
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