CMS Posts Medicare Program Integrity Manual Updates: Changes Affect SNF Enrollment, CHOWs, and Reenrollment Beginning January 2023

• By: Angela Westhoff
• On: 11/17/2022 14:15:42
• In: Quality/Regulatory

CMS posted a display copy of updates to the calendar year (CY) Final Rule for the 2023 Medicare Physician Fee Schedule (PFS), other Medicare Part B policies, and Medicare and Medicaid provider enrollment policies. Many of these updates impact skilled nursing providers. 

Most notably – effective January 6, 2023 – SNFs that are initially enrolling or undergoing a change in ownership (CHOW) fall within the “high” screening category under 42 CFR § 424.518. SNF revalidations are processed at the “moderate” screening level. These changes include the addition of site visits for all SNF providers and fingerprint-based criminal background checks for 5 percent or greater direct and indirect owners at specific times. 

The Federal Register version of the Final Rule will be posted on November 18.

AHCA/NCAL has developed a detailed summary of the changes impacting SNF provider enrollment, revalidation, CHOW, and reenrollment. Note: A member log-in is required to view the summary. 
 
Staff contact: awesthoff@mehca.org