CMS proposes expanded authority to revoke Medicare enrollment, citing fraud safeguards

CMS is proposing new rules to expand its authority to revoke Medicare billing privileges and expedite enrollment revocation for providers deemed 'problematic.' The agency cites program integrity and fraud prevention as core goals. The proposal follows earlier signals CMS is targeting aggressive enrollment safeguards. If finalized, this would give CMS broader latitude to act on providers with patterns of problematic billing or compliance issues. The comment period will determine the final scope. This is part of a wider CMS push on program integrity. While aimed at fraud, practices should audit their own enrollment data in PECOS and ensure all practice locations and reassignments are current and accurate. The comment period is a key window to influence the final rule's definitions of 'problematic.'