New CMS Program Integrity Final Rule Is Here—Guideposts for Operationalizing the New Disclosure Requirements
Recorded On: 11/06/2019
Time: 2:00-3:30 PM Eastern (90 minutes)
Session Format: Live Webinar
CLE Credit Available: Yes
On September 5, 2019, CMS released a final rule with comment period called "Medicare, Medicaid, and Children's Health Insurance Programs; Program Integrity Enhancements to the Provider Enrollment Process." Finalizing a proposed rule from 2016, CMS has imposed new enrollment disclosure requirements and created new avenues for denying or revoking enrollments across the range of providers and suppliers that participate in Medicare, Medicaid, or CHIP. Beginning November 4, 2019, providers and suppliers will be required to disclose certain current or past “affiliations” with other providers and suppliers if those affiliated providers and suppliers have been subject to a “disclosable event.” One key to understanding the impact of this final rule is understanding the broad scope of both “affiliation” and “disclosable events.” Hospitals, SNFs, physicians, and other providers and suppliers will need to keep track of a new range of conduct among a new range of relationships. Failure to track and disclose these affiliations will be at one’s peril, as CMS has authority to deny or revoke an enrollment if it determines that an affiliation presents “an undue risk of fraud, waste, or abuse” or if the provider or supplier failed to disclose the affiliation. The goals of this webinar will be to describe key concepts in the final rule and give those representing providers and suppliers guideposts for how to operationalize the new affiliation tracking that CMS has imposed. The webinar will focus on practical examples and takeaways.
Level of Difficulty: Intermediate
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