CMS Change in Ownership Rules

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A recent OIG report statees, “Over three-quarters of Medicare providers in our review had owner names on record with CMS that did not match those that providers submitted to OIG. Further, nearly all providers in our review had owner names on record with CMS that did not match those on record with State Medicaid programs. The prevalence of nonmatching owner names raises concern about the completeness and accuracy of information about Medicare providers’ ownership. It also demonstrates that providers may not be complying with the requirement to report ownership changes to CMS.”

The OIG further recommended that the following actions be taken. “We recommend that CMS (1) review providers that submitted nonmatching owner names and take appropriate action, (2) educate providers on the requirement to report changes of ownership, (3) increase coordination with State Medicaid programs on the collection and verification of provider ownership information in Medicare and Medicaid, and (4) ensure that its contractors check exclusions databases as required. CMS concurred with all of our recommendations.

In order to education a MLN Matters® Number: SE1617 from the Centers for Medicare and Medicaid Services (CMS) reminds providers of the reporting rules during a Change of Ownership.

A supplier of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS), must report any changes in information supplied on the enrollment application within 30 days of the change to the National Supplier Clearinghouse (NSC) (42 CFR §424.57(c)(2)).

 

 

Selling, Purchasing and Change of Ownership (CHOW) issues have been added to the next AABCP Post Mastectomy Compliance Boot Camp.