LeadingAge heard from members with concerns about subcontractors without proper identification or documentation showing up for unannounced visits and who are required to take photos of the nursing home and skilled rehab. The inspector may identify themselves as being a CMS sub-contractor or working for a Medicare Administrative Contractor (MAC).
LeadingAge reported concerns to CMS with specific examples. After verification with CMS, LeadingAge received the following information to inform nursing home members of what to expect. According to CMS, the inspector needs to provide a photo ID (they do not have a government employee or contractor identification) and a CMS letter of authorization. This letter has a QR code that links to the MAC contact list for providers to call if they would like to verify the visit. Providers may review but not obtain or copy the identification or letter.
This process may be found online from CMS outreach at Medicare Provider Enrollment MLN (Enrollment tab, step 3). This verifies CMS’ authority to conduct visits on all providers and messaging was also issued in the MLN newsletter Provider & Supplier Enrollment Site Visits: CMS has Authority to Conduct.
