New CMS proposal gives agency broad new authority to deny, revoke Medicare enrollment

CMS has proposed a rule that would expand its authority to deny or revoke Medicare enrollment under several new circumstances. The agency seeks new discretion to act based on affiliations with previously sanctioned entities, patterns of ordering unnecessary services, and failure to report changes in ownership or practice location. This follows other recent CMS proposals aimed at program integrity, signaling a more aggressive enforcement posture. The proposal is open for comment. Practices should ensure their Medicare enrollment records in PECOS are current and review any corporate affiliations that could trigger scrutiny under the new rules.