CMS Pitches Sweeping Changes to Rules for Maintaining Medicare Billing Privileges

A one-paragraph statement in the proposed rule calls for applying Medicare enrollment approval and revocation rules for opioid treatment programs to all physicians and other eligible professionals. The proposal would allow CMS to revoke Medicare billing privileges for physicians, advance practice nurses and others for a variety of reasons.

If finalized, the rule would allow CMS to revoke the Medicare billing privileges of any physician who has “been subject to prior action from a state oversight board, federal or state health care program, Independent Review Organization (IRO) determination(s), or any other equivalent governmental body or program that oversees, regulates, or administers the provision of healthcare with underlying facts reflecting improper physician or other eligible professional conduct that led to patient harm.”

Source: https://www.beckershospitalreview.com/finance/cms-pitches-sweeping-changes-to-rules-for-maintaining-medicare-billing-privileges.html