CMS expands authority to exclude providers from Medicare
November 04, 2026
The Centers for Medicare and Medicaid Services published a final rule Wednesday expanding its ability to exclude providers from Medicare.
The agency has cited the policy as an anti-fraud tool, but critics have said it will harm good actors in the program.
“These changes will help protect seniors, safeguard taxpayer dollars and preserve access to the care beneficiaries need,” CMS Administrator Dr. Mehmet Oz said in a news release.
The finalized update will allow CMS to hasten the process for barring providers and suppliers from Medicare reimbursement starting next year. It also expands the list of reasons it can do so, including changes in majority ownership or the suspension of an organization’s managing employees from Medicaid or other federal programs.
CMS will make all grounds to remove providers and suppliers retroactive to the date of alleged noncompliance, and providers will have to repay Medicare for claims filed from the date of alleged noncompliance forward. To read the full article, click here.