7 Things You Need to Know About the CMS Preclusion List

In 2019, the Centers for Medicare and Medicaid (CMS) published new rules for providers and plans, which included the Medicare Preclusion List, a list of providers who are precluded from receiving payment for Medicare Advantage (MA) items and services or Part D drugs furnished or prescribed to Medicare beneficiaries. Created to replace the MA and prescriber enrollment requirements that previously existed, compliance with the list is crucial for health care providers. The Medicare Preclusion is not publicly available, but includes those who are currently revoked from Medicare, under an active re-enrollment bar, and those who have engaged in behavior for which CMS could have revoked the individual or entity to the extent applicable if they had been enrolled in Medicare.

 

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Post By Ken Shafton (399 Posts)