March 2, 2016

Dealing with a blacklisted provider? You'll have to disclose that, CMS says.

Daily Briefing

CMS has proposed a rule that would require providers and suppliers to disclose professional relationships with those who are banned from the programs or who owe the government money, Virgil Dickson reports for Modern Healthcare.

The proposed rule, which was required under the Affordable Care Act, also would:

  • Extend Medicare re-enrollment bans from three to 10 years; and
  • Give CMS the authority to reject or revoke a provider's or supplier's enrollment in Medicare.

CMS would add three additional years to the ban if providers or suppliers attempted to work around the sanction by billing the programs through another party. Providers and suppliers could be banned from Medicare for up to 20 years for a second offense.

ProPublica: Medicare wants to ban harmful prescribers

The proposed rule also would require providers to be enrolled in Medicare under an approved status or to have opted out of the program before ordering, certifying, referring, or prescribing any Medicare Part A or B services, items, or drugs.

CMS estimates that the rule, if finalized, would cost providers and suppliers more than $900 million over the first three years of the enactment.

It is unclear how many providers or suppliers could be denied billing privileges under the proposal.

CMS is accepting public comments on the proposal until May 1 (Dickson, Modern Healthcare, 2/25).

More from today's Daily Briefing
  1. Current ArticleDealing with a blacklisted provider? You'll have to disclose that, CMS says.

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