LeadingAge NY Meets with CMS, DOH on Provider Enrollment Site Visits
(Oct. 8, 2024) LeadingAge New York and other provider associations met with the Department of Health and representatives of the Centers for Medicare and Medicaid Services (CMS) on Oct. 2nd to raise concerns about the recent wave of CMS provider enrollment site visits of nursing homes. Several LeadingAge NY members have received unannounced site visits in recent months by inspectors claiming to represent CMS and seeking to photograph areas of the facility. The CMS representatives at the meeting explained that these site visits apply to a variety of provider types, with the goal of ensuring that the facility is, in fact, in operation at the appropriate location and that staff are present in the building. A slide deck about enrollment site visits is available here.
During the site visit, the inspector will photograph the exterior of the facility and possibly the reception area. They should not photograph resident rooms or residents themselves. Inspectors conducting these site visits should present a letter of authorization issued and signed by CMS and photo identification. Providers may request to review these documents, but may not copy or retain them. The CMS letter has a QR code on the reverse side which leads to a website that provides additional information and contact information for the Medicare Administrative Contractor (MAC). The MAC should be able to verify that an inspector is conducting a CMS ordered site visit and address any concerns regarding the visit.
The site visits are conducted by CMS contractors or their subcontractors. The contractor for the Eastern US region is Palmetto GBA, which has subcontracted with the following companies:
- Overland Solutions, Inc., an affiliate of EXL
- Information Discovery Services
- Compliance Review, Inc.
- National Creditors Connection, Inc.
If a facility experiences problems or questions regarding a site visit, it should first contact the MAC, National Government Services, Inc., at 855-593-8047. The CMS representatives indicated that the MAC call center agents should be trained to address these inquiries. Facilities may also contact CMS here. LeadingAge NY and LeadingAge National are interested in hearing about any issues or concerns with the site visits. Please contact Karen Lipson at the email below to share your concerns.
More information about provider enrollment site visits is available here.
Contact: Karen Lipson, klipson@leadingageny.org.