Medicare Provider and Supplier Enrollment Requirements: Expanded CMS Oversight Authority and Recent Trends
Stay of Enrollment Status; Mental Health and Family Therapy Suppliers; Revocation Effective Date and Timeline

Course Details
- smart_display Format
On-Demand
- signal_cellular_alt Difficulty Level
Intermediate
- work Practice Area
Health
- event Date
Monday, March 10, 2025
- schedule Time
1:00 p.m. ET./10:00 a.m. PT
- timer Program Length
90 minutes
-
This 90-minute webinar is eligible in most states for 1.5 CLE credits.
This CLE webinar will guide healthcare practitioners through the most recent CMS Medicare provider and supplier enrollment regulations at 42 C.F.R. 424, Subpart P and related CMS guidance which allows CMS to revoke or deny enrollment in the Medicare and contains significant compliance obligations. The panel will discuss the potentially harsh consequences of noncompliance and best practices to mitigate risk.
Faculty

Ms. Reignley provides strategic legal, regulatory and compliance counsel to for-profit and nonprofit hospitals, health systems, other healthcare providers, life sciences and technology companies. She counsels clients on interpretation and risk mitigation under the Anti-Kickback Statute, Stark Law and EKRA. She also advises on internal and government investigations related to the False Claims Act, Stark Law and Anti-Kickback Statue. Ms. Reignley advises clients involved in digital health on the applicable legal and regulatory infrastructure, with a particular focus on remote patient monitoring programs. She also advises Medicare providers, consultants and vendors on a wide range of business, legal and regulatory issues. She has extensive experience advising clients on Medicare and Medicaid fee-for-service reimbursement, billing and coding. She also advises clients on professional licensure, scope of practice, physician and health care professional clinician relationships and supervision, together with overall corporate compliance.

Ms. Wallace focuses her practice on complex regulatory and transactional counseling to healthcare organizations, including health systems, hospitals, ambulatory surgery centers, physician groups, dental providers, behavioral health clients, integrated delivery systems, academic medical centers, DMEPOS and pharmaceutical manufacturers and suppliers, home health agencies, and venture capital and private equity firms and their health-related portfolio companies. She concentrates her regulatory practice on healthcare fraud and abuse, Medicare and Medicaid enrollment, reimbursement and billing, legal assessments and audits, compliance programs, and other general regulatory matters including licensure, survey/certification and accreditation. Ms. Wallace’s transactional practice includes mergers, acquisitions and affiliations, divestitures, hospital/physician joint ventures and corporate reorganization.

Ms. Dimick provides strategic regulatory counseling for a wide variety of healthcare industry members. She delivers creative and practical legal solutions for digital health initiatives that comply with the constantly evolving regulatory landscape. Ms. Dimick counsels healthcare providers, health systems, private equity firms and their portfolio companies, and technology companies on regulatory, transactional and compliance matters. She advises on professional and facility licensure, corporate practice of medicine requirements, professional scope of practice and supervision, prescribing and reimbursement. She also assists clients with the development and implementation of telehealth programs.
Description
Enrolling and maintaining Medicare billing privileges requires Medicare providers and suppliers to comply with the detailed enrollment regulations at 42 C.F.R. 424, Subpart P and related CMS guidance. Expanded Medicare coverage for telehealth services has led to an increase in virtual services and CMS has revised its guidance for providers enrolling to furnish these services. In recent years, revised and expanded authorities have imposed additional disclosure obligations on providers and suppliers to establish and maintain Medicare enrollment. Finally, changes to Medicare enrollment requirements will subject certain providers to a provisional period of enhanced oversight.
Listen as our expert panel guides practitioners through the CMS enrollment requirements for providers and suppliers and recent updates. The panel will also discuss the consequences of noncompliance and provide best practices to mitigate risk.
Outline
- Introduction
- Medicare enrollment for telehealth and virtual care providers
- Provisional period of enhanced oversight for certain providers
- Enhanced disclosure obligations including for skilled nursing facilities
- Change of ownership reporting and trends in ownership disclosures
- Revocation and deactivation of Medicare enrollment and consequences
- Best practices for compliance
Benefits
The panel will review these and other important issues:
- What authority does CMS have to deny or revoke Medicare enrollment applications?
- What disclosure requirements apply to Medicare providers and suppliers?
- How do Medicare enrollment requirements apply to telehealth and virtual care providers?
- What actions must a seller and buyer take when there is a change of ownership of a Medicare provider or supplier?
- What are the potential consequences of noncompliance?
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