CMS Issues Reminder to Report Change of Ownership to Medicare

Have you checked lately? Do the owner names for your practice that are on record with the Centers for Medicare and Medicaid Services (CMS) match those that you have provided to the Office of Inspector General and your state Medicaid programs?

A recent Office of Inspector General (OIG) report revealed that more than 75% of Medicare providers had owner names with CMS that did not match those submitted to the OIG and to Medicaid programs. 

These adverse findings caused concern at CMS about how accurate and complete the information is that is provided for Medicare providers. You can read the reminder from CMS here.

This is not a small matter and should be of concern to all health care providers and suppliers who want to be enrolled with Medicare in order to treat Medicare beneficiaries. Failing to comply with reporting requirements, including problems with accuracy, may cause Medicare billing privileges to be revoked.

What Is a Change in Ownership?

A change in ownership, or CHOW, occurs when a provider or supplier that is enrolled with Medicare is bought or leased by another business. The CHOW transfers the prior owner’s Medicare Identification Number and provider agreement – including outstanding Medicare debts – to the new owner. The new owner can reject the existing provider agreement; in this case, the CHOW will be considered an initial enrollment for the new owner. 

Reporting Requirements and Timing

CMS requires that all physicians, as well as other health care providers such as physician assistants and nurse practitioners, report any change in ownership as well as adverse legal actions and change in practice location within 30 days of the change. Any other change, such as a change in the legal name of the business, must be reported within 90 days. Changes can be reported through the PECOS system or by using the appropriate CMS-855 form.

Those who supply durable medical equipment, prosthetics, orthotics and supplies must report information changes on enrollment applications to the National Supplier Clearinghouse within 30 days. Independent diagnostic testing facilities also have 30 days to report changes online or via the appropriate CMS-855 form. 

Let Us Manage All Your Payer Enrollment Services

If you require medical credentialing and payer enrollment needs for your practice or medical facility, please contact 1st Assistant. Our experienced and dedicated specialists will provide all credentialing and enrollment services quickly and will monitor your account for ongoing updates and re-attestations. Heidi Henderson, our company owner and President, is eager to meet you and discuss your payer enrollment needs. Please call us at 512.201.2668 or contact us via the website.