This week ASGE delivered comments to the Centers for Medicare & Medicaid Services (CMS) in response to proposals that would expand the Agency’s ability to deny and revoke Medicare provider enrollment.
The proposals were included in the CY 2027 Home Health Prospective Payment System Proposed Rule and are tied to CMS’ initiatives at address fraud, waste, and abuse in the Medicare system.
As previously reported by ASGE, the proposals, if finalized, would apply across Medicare provider and supplier types. In its letter, ASGE raised concerns about the breadth of CMS’ proposal to deny or revoke enrollment when a provider, supplier, or associated owner or official has been convicted within the past 10 years of a federal or state misdemeanor involving sexual assault or financial misconduct that CMS deems detrimental to the Medicare program. ASGE cautioned that holding an entire organization accountable for an individual’s isolated misconduct could “produce disproportionate consequences for patients, providers, and the Medicare program.”
The rule also proposes requiring all Part B suppliers, including clinics and group practices, to disclose on enrollment applications whether they are owned by a private equity company or Real Estate Investment Trust, a requirement already applicable to skilled nursing facilities. ASGE cautioned that such disclosures could be used as a proxy for wrongdoing or program-integrity risk and urged CMS to establish safeguards against discrimination.