CMS: Medicare Provider Enrollment Changes in Home Health CY27 Proposed Rule

As part of the Trump administration's ongoing effort to control waste, fraud, and abuse within the Medicare program, the Centers for Medicare and Medicaid Services (CMS) included a number of proposals in the CY2027 Home Health Proposed Rule which will impact all Medicare providers including home health, hospice, and skilled nursing providers.

The agency proposes to change the regulatory language around retroactive revocations, making them effective to the date of noncompliance for all revocation grounds. Previously, revocations were effective prospectively 30 days after the date that CMS or the CMS contractor mailed a notice to the effected provider.

Additionally, CMS is expanding the reasons for revocation or denial of a provider's Medicare enrollment. These revocations include suspensions/revocations and issues with managing employees or other similarly owned organizations. For example, CMS proposes to expand the ability to revoke/suspend enrollment for an owner or managing employee's misdemeanor convictions related to sexual assault or financial misconduct within the past 10 years. CMS also proposes to suspended or revoked enrollment when the provider's license has been suspended or revoked in another state or the provider has been suspended or revoked from Medicaid or another federal health care program.

LeadingAge will have a detailed article for members in the coming days on all the program integrity proposals in the CY2027 Home Health Proposed Rule.