Is Your Medicare Enrollment at Risk?
CMS requires transparency regarding the ownership and management of certain healthcare facilities. If the required “additional disclosable party” information is not received, the provider’s ability to bill Medicare will be impacted due to potential denial or revocation of their Medicare enrollment.
Under Medicare rules, “additional disclosable parties” are individuals or entities that:
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Have ownership or managing control interests in the provider or supplier,
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Exercise operational or managerial control, or
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Have an indirect ownership interest through another entity.
This disclosure is required to maintain transparency and prevent fraud, waste, and abuse.
Medicare Requirements: The Centers for Medicare & Medicaid Services (CMS) has implemented rules requiring facilities to disclose this information, particularly on the Form CMS-855A, which is used for enrollment and revalidation.
Consequences of Non-Compliance
Failure to provide accurate and timely disclosure of this information can lead to:
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Denial or Revocation of Enrollment: Providers who fail to meet the reporting obligations risk denial or revocation of their Medicare enrollment.
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Billing Restrictions: Without valid enrollment, providers cannot bill Medicare for services rendered.
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Reapplication Restrictions: Providers with denied or revoked enrollment may face restrictions on reapplying for enrollment, potentially for an extended period.
Call to Action
Assure you have disclosed the requested information on Form CMS-855A by 8/1/2025 so your Medicare enrollment is not at risk.
