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Centers for Medicaid Services Delays Affiliation Disclosure Requirements

On March 24, 2021, in an MLN Matters Special Edition Article SE21003 Centers for Medicaid Services announced they will not begin updating the Form CMS-855 applications with affiliation disclosure sections for at least another 12 months. ....

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Report on Medicare Compliance Volume 30, Number 13. News Briefs: April 2021 | Health Care Compliance Association (HCCA)

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Because of the COVID-19 pandemic, CMS said April 1 that it won’t update the 855 enrollment form with sections on “affiliation disclosures,” as planned in a 2019 program integrity regulation,
[1]
MLN Matters (SE21003).
[2] It also will adopt a phased-in approach to affiliation disclosures. The regulation, which implements provisions of the Affordable Care Act, is designed to keep, or kick, providers out of Medicare if they pose an “undue risk” of fraud, waste or abuse. It requires providers to disclose “affiliations” with other providers who have been suspended or excluded from Medicare, Medicaid or the Children’s Health Insurance Program (CHIP); owe the programs money; or had their billing privileges denied or revoked. ....

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New Medicare Provider Affiliation Reporting Requirements Delayed | Baker Ober Health Law

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In a March 24, 2021 CMS MLN Matters Special Edition Article, SE21003, CMS announced that [i]n light of the pandemic and various other factors, we will not begin updating the Form CMS-855 applications with affiliation disclosure sections for at least another 12 months. The Program Integrity Enhancements to the Provider Enrollment Process Rule (Medicare Provider Affiliation Rule) was finalized on September 10, 2019, requiring,
inter alia, providers and suppliers initially enrolling or revalidating to disclose all affiliations that it or any of its owning or managing employees or organizations have had within the previous five years with a currently or formerly enrolled Medicare, Medicaid, or CHIP provider or supplier that has a disclosable event. The terms affiliation and disclosable event are defined in 42 C.F.R. § 424.502. ....

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