The CY 2024 Home Health final rule contained changes to provisions about Medicare provider enrollment. CMS has released guidance for providers as well as Medicare Administrative Contractors on these changes which will go live January 2, 2023. These include, but aren’t limited to:
- Section 10.1.1: CMS revised the definition of managing employee. For purposes of this definition of managing employee, this includes, but isn’t limited to, a hospice or skilled nursing facility administrator and a hospice or skilled nursing facility medical director.
- Section 10.6.1.1.5: CMS added this section to give details on reporting HHA and hospice majority ownership changes occurring within 36 months after the effective date of the HHA’s or hospice’s initial enrollment in Medicare or within 36 months after the HHA’s or hospice most recent change in majority ownership.
- Section 10.6.15: CMS updated this section to show the revised screening requirements for hospices which move hospice into the high level of categorial risk-screening.
- Section 10.4.8: CMS updated this section to state that provider/supplier that do not submit any Medicare claims for 6 consecutive calendar months will be deactivated. The 6-month period will begin the 1st day of the 1st month without a claim submission through the last day of the 6th month without a submitted claim.
- Section 10.6.15: CMS added to this section that the fingerprinting requirements outlined in §424.518(c)(2)(ii) will be required upon the provider’s or supplier’s (including home health agencies, hospices, and skilled nursing facilities)—
- New/initial enrollment; or
- Revalidation after CMS waived the fingerprinting requirements, under the circumstances described in § 424.518(c)(1)(viii), when the provider or supplier initially enrolled in Medicare.
