Tucked into the CY2027 Home Health Prospective Payment System (PPS) proposed rule released by the Centers for Medicare and Medicaid Services (CMS) on July 1 are new provider enrollment provisions that would apply across Medicare provider and supplier types.
Specifically, the proposed rule adds grounds for denying or revoking a provider’s or supplier’s Medicare enrollment, including if the enrollment is deemed to present a high risk of fraud, waste or abuse due to the provider’s/supplier’s location “within a limited geographic area that has an excessive number of providers and suppliers.” CMS’ clarifies, however, it understands that many physicians and practitioners practice in the same building, complex, or other small area, and, therefore, they should not assume their enrollment would be revoked merely because they operate near other providers.
The rule also proposes to require all Part B suppliers, including clinics and group practices, to identify on enrollment applications whether they are a private equity company or Real Estate Investment Trust. This requirement already applies to skilled nursing facilities.
ASGE is in the process of analyzing the proposed rule. CMS is accepting public comment through August 31.