News & Analysis as of

Final Rules Medicaid Enrollment

Mintz - Health Care Viewpoints

Unpacking CMS’s 2025 DSNP Changes: Considerations for Medicare Advantage Organizations

As part of its 2025 Medicare Advantage and Part D Final Rule (the Final Rule), the Centers for Medicare & Medicaid Services (CMS) made a number of enrollment changes impacting dual eligible special needs plans (DSNPs). The...more

King & Spalding

Biden Administration Streamlines CHIP and Medicaid Enrollment, Expands Protections for Covered Population

King & Spalding on

Last week, the Biden-Harris administration (the Administration) announced a new rule simplifying the process for enrolling in Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program (BHP)....more

Baker Donelson

Medicare Revocation Consequences Worsened – Further Reenrollment Restrictions

Baker Donelson on

CMS recently finalized the most significant changes to enrollment since the 2006 enrollment rules were initially adopted. Overview of the New Rule - In its "Program Integrity Enhancements to the Provider Enrollment...more

Dorsey & Whitney LLP

New Disclosure Requirements to be Phased-In to CMS Enrollment and Revalidation Process

Dorsey & Whitney LLP on

On September 5, 2019, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (“Final Rule”) effective November 4, 2019, which increases disclosure requirements for the provider and supplier enrollment and...more

Steptoe & Johnson PLLC

CMS’ Expanded Revocation Authority Threatens Health Care Providers’ Medicare Enrollment

Steptoe & Johnson PLLC on

On September 5, 2019, the Centers for Medicare & Medicaid Services (CMS) announced a final rule expanding CMS’ authority to deny or revoke enrollment in the Medicare program as a result of “bad actor” affiliations. Providers...more

McDermott Will & Emery

CMS Final Rule Strengthens Integrity of Medicare Provider Enrollment Process

McDermott Will & Emery on

On September 10, 2019, the US Department of Health and Human Services Centers for Medicare & Medicaid Services (CMS) published a final rule (Final Rule) expanding Medicare, Medicaid and Children’s Health Insurance Program...more

ArentFox Schiff

Guilt by Affiliation: New CMS Regulations Require Provider Disclosure of Past Association with “Bad Actors”

ArentFox Schiff on

On September 10, 2019, the Centers for Medicare and Medicaid Services (CMS) issued a final rule with comment period, titled Program Integrity Enhancements to the Provider Enrollment Process (the “Final Rule”), which enhances...more

Bass, Berry & Sims PLC

Providers and Suppliers: Do You Have Skeletons in Your Enrollment Closet?

Bass, Berry & Sims PLC on

On September 10, 2019, the Centers for Medicare & Medicaid Services (CMS) published a final rule significantly expanding its authority to deny or revoke participation in Medicare, Medicaid or the Children’s Health Insurance...more

Verrill

CMS Cracking Down on Health Care Fraud and Abuse

Verrill on

To increase provider and supplier transparency and accountability, the Centers for Medicare & Medicaid Services (“CMS”) recently issued a final rule (“Final Rule”) with comment period that allows CMS greater ability to...more

Mintz - Health Care Viewpoints

Key Takeaways from CMS’s Final Rule Requiring the Disclosure of Affiliates during Provider Enrollment

The Centers for Medicare & Medicare Services (CMS) recently published a final rule with comment period (the “Final Rule”) that is designed to increase CMS’s ability to identify and prevent bad actors from participating in...more

White and Williams LLP

Are You Your Brother’s Keeper? CMS Finalizes Rule to Reduce Fraud in Federal Health Insurance Programs

White and Williams LLP on

On September 10, 2019, the Centers for Medicare & Medicaid Services (CMS) published a final rule with comment, entitled “Program Integrity Enhancements to the Provider Enrollment Process” (Final Rule), which CMS claims will...more

Sheppard Mullin Richter & Hampton LLP

CMS Finalizes Rule Expanding its Authority to Deny and Revoke Medicare Program Enrollment, Among Other Changes

On September 5, 2019, the Centers for Medicare and Medicaid Services (“CMS”) released a final rule with comment period entitled, “Program Integrity Enhancements to the Provider Enrollment Process” (the “Final Rule”). The...more

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