Enrollment

News & Analysis as of

CMS Announces Changes to HHA/Ambulance Supplier Enrollment Moratoria, New Exception Process Demo

CMS has announced a number of changes to its temporary Medicare enrollment moratoria for certain provider types in select geographic areas as a mechanism to address fraud, waste, and abuse. First, CMS is extending for six...more

New Medicare Enrollment Requirements for MA Providers

In Depth - The Medicare Physician Fee Schedule proposed rule released by the Centers for Medicare & Medicaid Services (CMS) on July 7, 2016, (the Proposed Rule) requires certain providers and suppliers furnishing health...more

CMS Proposes Medicare Physician Fee Schedule Update for 2017

The Centers for Medicare & Medicaid Services (CMS) has published its proposed rule to update the Medicare physician fee schedule (MPFS) for calendar year (CY) 2017. The proposed rule contains numerous Medicare payment and...more

The June 30th Enrollment Deadline for ESTMA Compliance is Looming

Natural Resources Canada (NRCan) is calling for those entities required to report under the Extractive Sector Transparency Measures Act (ESTMA) to enroll for an ESTMA identification number by submitting a Contact Form to...more

Manatt on Medicaid: Beneficiary Support and Enrollment Requirements

On April 25, 2016, the Centers for Medicare and Medicaid Services (CMS) released its final rule that significantly overhauls regulations governing Medicaid managed care. The final rule establishes new requirements for...more

CMS Issues Revised Rules for CO-OPs and Special Enrollment Periods

As implementation of the Affordable Care Act (ACA) continues, the federal government continues to make adjustments to its rules to respond to the needs and circumstances arising from this transformational legislation. On...more

OIG Issues Report on Enhanced Medicare Screening

After reviewing Medicare and Medicaid enrollment and revalidation applications, the U.S. Department of Health & Human Services, Office of Inspector General (OIG) issued a report titled Enhanced Enrollment Screening of...more

Manatt on Health Reform: Weekly Highlights - April 2016

Oklahoma proposes Medicaid coverage for 175,000 currently uninsured; a report finds State-based Marketplaces boost Medicaid enrollment growth rates; and CMS issues a final rule on mental health parity in Medicaid and CHIP....more

All Texas Medicaid Providers Must Re-Enroll by June 17th...or Else!

As a requirement of the Patient Protection and Affordable Care Act ("PPACA"), all Texas Medicaid providers, including ordering and referring providers, must revalidate their enrollment in the Texas Medicaid program if they...more

Proposed Enrollment Rule Changes - de Facto Exclusion?

Proposed rules, touted as enhancing the provider enrollment process, would provide CMS with sanction authority that closely parallels the OIG’s exclusion authority. Under the proposed rules, CMS would have expanded bases to...more

CMS Delays Enforcement of Medicare Part D Prescriber Enrollment Requirement Until February 1, 2017

CMS is delaying until February 1, 2017 enforcement of previously-adopted regulations that require physicians and other eligible professionals who prescribe Part D drugs to be enrolled in Medicare (or have a valid opt-out...more

A&B Healthcare Week in Review

I. REGULATIONS, NOTICES, & GUIDANCE - On March 15, 2016, the Centers for Disease Control and Prevention (CDC) issued voluntary guidelines entitled, “CDC Guidelines for Prescribing Opioids for Chronic Pain — United...more

CMS Begins Cycle 2 of Provider/Supplier Enrollment Revalidation

The Centers for Medicare & Medicaid Services (CMS) Division of Enrollment Operations is beginning Cycle 2 of the provider and supplier revalidation process, as required under Section 6401 (a) of the Affordable Care Act. CMS...more

Program Integrity Changes to the Medicare Provider Enrollment Process

On March 1, 2016, the U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services (CMS) published a proposed rule (Proposed Rule) entitled “Medicare, Medicaid, and Children’s Health Insurance...more

Manatt on Marketplaces: Vermont Posts State Innovation Proposal to Waive SHOP Requirement

Vermont posted a draft 1332 waiver proposal for public comment on February 8, 2016. Vermont proposes to eliminate the ACA requirement that small employers enroll through a Small Business Health Options Program (SHOP) web...more

CMS Releases Proposed Rule and New Tactics Aimed at Strengthening Provider Enrollment Screening

On February 22, 2016, CMS announced on its blog four new enrollment tactics designed to strengthen provider enrollment screening efforts. Just three days later, on February 25, 2016, CMS released a proposed rule that would...more

A&B Healthcare Week in Review

I. REGULATIONS, NOTICES, & GUIDANCE - On February 24, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a guidance entitled, “Special Enrollment Confirmation Process” that will enhance program integrity...more

ORPP Update: Enrollment and Phase-in of Contributions Delayed

The Ontario and federal governments announced on February 16, 2016 that they have reached an agreement regarding the Ontario Retirement Pension Plan (ORPP) and improving pensions for Canadians. With contributions originally...more

Recent Decisions Applying the Covalt and Hartwell Test

Two California Courts of Appeal recently reviewed decisions involving the California Public Utilities Commission in a pair of cases that build on the principles established by the California Supreme Court in Covalt and...more

Employers’ Guide to the Ontario Retirement Pension Plan

The Ontario Retirement Pension Plan (the ORPP), will be a provincially-managed plan that, like the Canada Pension Plan, will be funded by equal co-contributions from both employers and employees. It will come into effect as...more

Manatt on Health Reform: Weekly Highlights - February 2016

Virginia submits a $1 billion DSRIP application; Michigan's Governor will request authority to extend Medicaid coverage to Flint residents aged 21 and under; and Hawaii reinstates small business tax credits in its updated...more

CBO’s Budget Forecast and the Silver Tsunami

This week, the Congressional Budget Office (CBO) released a projection that shows Medicare enrollment will grow by more than 30 percent in the next decade alone, and the number of seniors will steadily grow from 55 million...more

Manatt on Health Reform: Weekly Highlights - January 2016 #2

Minnesota's Task Force recommends maintaining their State-based Marketplace while Oregon considers bringing back theirs; CMS narrows the criteria for special enrollment periods; and President Obama seeks an extension of full...more

CMS Issues Final Rule on Enhanced Funding for Certain Medicaid Eligibility & Enrollment Systems

On December 4, 2015, CMS published a final rule that extends enhanced federal funding for the design, development, installation, or enhancement of Medicaid eligibility and enrollment systems. The rule also updates standards...more

Manatt on Health Reform: Weekly Highlights - December 2015 #2

A flurry of support for Medicaid expansion this week…with Virginia hospitals backing a provider assessment, Wyoming's Governor putting forth a budget initiative, and Arkansas announcing plans to extend its waiver. Meanwhile,...more

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