CMS Administrative Memo Revised: Transition Several Providers and Suppliers and Provide Additional Guidance and Updates to the Standard Operating Procedures 

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

CMS revised Admin Info: 22-02-ALL on May 19, 2022.

To improve efficiency in the enrollment process for Medicare-participating certified providers and suppliers, CMS is transitioning certain certification-enrollment functions performed by the CMS Locations to CMS’ CPI/PEOG and the MACs. The transition of workload will continue to occur with implementation rollouts projected throughout CY2022.

The SOP provides a general overview of processing instructions for:

• Changes of Ownership (CHOW); 

• Administrative Changes also known as Changes of Information (such as address changes, name changes, additional service locations, relocations, etc.); and,• Initial Certification.

The SOP identifies processing instructions and highlights the applicability of all providers/suppliers impacted, which will be transitioned. This process commenced with Skilled SNFs on January 3, 2022. The next providers/suppliers to transition are ASCs, CMHCs, CORFs, FQHCs, HHAs, OPT/OSP, and PXR and will commence on May 30, 2022, and the remaining providers/suppliers at a later date in 2022.

While the instructions in the general SOP issued on December 21, 2021 remain the general instructions for processing, this memorandum provides an addendum with additional guidance for the providers/supplier transitioning beginning on May 30, 2022. We have also added minor clarifications within the general SOP based on inquiries received since the January 3, 2022, implementation of SNFs.

This guidance applies to all CMS-855 applications that have not yet been forwarded to the CMS Location with a recommendation from the SA. This includes all new CMS-855 applications received by the MAC, and any certification packets recommended for approval by the MAC but are currently in a pending status with the SA.

Keep reading. There’s a lot of red (revisions/updates) to review. This Memo is 6 pages in length with 3 Attachments starting on page 7 through 57.

The SOP covers multiple parts to include 1) CHOWs; 2) Administrative Changes; 3) Initial Certification and Enrollment. The SAs, CPI/PEOG, and the MACs will follow the general guidance provided in the SOP, however this Addendum (#3 – beginning on page 43) also covers provider/supplier differences, nuances, and areas specific to Ambulatory Surgical Centers (ASCs), Community Mental Health Centers (CMHCs); Comprehensive Outpatient Rehabilitation Facilities (CORFs); Federally Qualified Health Centers (FQHCs); Home Health Agencies (HHA), Outpatient Physical Therapy/Outpatient Speech Pathology (OPT/OSP) and Portable X-Ray (PXR) Providers.