Urge CMS to rescind the proposed rules for Medicare enrollment changes that unduly burden and penalize good actors. 

The proposed rule would make these changes:

Managing Employee: CMS proposes to change the definition of managing employee to specifically include nursing directors, departmental heads, alternate administrators, and all other clinical personnel that “exercises operational or managerial control over, or who directly or indirectly conducts, the day-to-day operation of the provider or supplier.” This is a huge expansion of the definition and creates significant burdens on providers who would have to report on a much broader scope of staff on Medicare enrollment documents and keep these documents updated with each addition and departure of a managing employee. 

Affiliations: CMS currently requires providers to report on affiliations (focused on ownership and management) for the previous five years. CMS proposes removing the five-year lookback and expanding the definition to encompass any point in the provider’s enrollment, regardless of how long the affiliation occurred. CMS is also expanding the definition to include: 1) an interest in which individuals or entities—or any of their “owning or managing employees or organizations”—exercise control or conduct day-to-day operations of another organization; and 2) any marketing, business, fulfillment, financial, managerial, or beneficiary relationships. Many nonprofit aging services providers have been enrolled in Medicare for decades. It is infeasible to ask an organization for details on multiple decades of affiliations. 

Finally, several enrollment denial and revocation reasons are proposed that would apply to the expanded definition of managing employees. For example, providers could be denied new enrollments including new branches if a managing employee of that entity has unpaid Medicare debt or previous payment suspensions.

Take action now and tell CMS to stop punishing good actors Medicare providers.