CMS Proposed Rule Would Expand Medicare Enrollment Denial and Revocation Authority

Short summary

CMS proposed a rule expanding its authority to deny and revoke Medicare enrollment, including retroactive revocations with payment clawbacks estimated to save $82M annually. The rule would let CMS revoke enrollment based on assessed fraud risk without actual fraud findings and extend denial grounds to providers' business associates. Comments are due August 31.

• •CMS proposes retroactive Medicare enrollment revocations with payment clawbacks, estimating $82M annual savings
• •New authority would allow revocation based on geographic risk assessment without actual fraud findings
• •Providers must vet key personnel and business partners for Medicare debt or adverse actions

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