As you may recall, in the CY 2023 Physician Fee Schedule final rule, CMS changed the provider enrollment risk level for SNFs from limited to high. One of the requirements added was that all SNFs would be required to have a provider enrollment site visit contractor visit the SNF for a brief period to take some photos to verify the location existed and appeared to be operating as a SNF. These Monday through Friday visits (no weekends or holidays) are unannounced. The contractor then sends the photos and a brief report to the Medicare Administrative Contractor (MAC) within a couple of days to add to the provider’s enrollment file.
From AHCA’s awareness, there was only sporadic provider enrollment site visit contractor activity in 2023, however, the activity appears to have picked up this summer.
What you need to know about Medicare Provider Enrollment Site Visits:
- The site visit is not a state survey, and the site visit contractor is not affiliated with the state agency.
- The site visit contractor has a letter and photo ID badge with the CMS and their contractors name logo.
- The contractors cannot leave a copy of the letter with the provider, but you can review the letter.
- Providers have the right to call their MAC to verify that the person/contractor is authorized.
2 Site Verification Services Contractors conduct site visits:
East: Palmetto GBA and its subcontractors:
- Overland Solutions, Inc, and affiliate of EXL
- Information Discovery Services
- Compliance Review, Inc
- National Creditors Connection, Inc
West: Deloitte Consulting, LLP, and its subcontractors:
- Nationwide Management Services, Inc.
- CSI Companies, Inc
- Arthur Lawrence management, LLC
- Computer Evidence Specialists, LLC
Resources:
- AHCA Blog Article – June 21
- CMS MLN Matters notice – June 20
- Medicare Provider Enrollment: Click on the Enrollment tab, and scroll to Step 3
- Medicare Fee-for-Service Provider Enrollment Contact List(PDF): Contact your Medicare Administrative Contractor to verify that the site visit is valid.
- Medicare Program Integrity Manual Chapter 10 – Section 10.6.20
Contact ldavenport@ihca.org if assistance is needed.