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CMS tightens Medicare fraud enforcement with sweeping new rule. The Centers for Medicare & Medicaid Services can now revoke Medicare billing privileges from providers whose parent companies or owners have violated federal healthcare rules — not just the providers themselves. The rule, part of the 2027 Home Health Prospective Payment System update, also requires home health and hospice providers to re-enroll after major ownership changes, and is projected to save taxpayers $82 million annually.
CMS cracks down on Medicare fraud with landmark ownership accountability rule
The CMS has finalized a sweeping rule that expands its authority to deny or revoke Medicare billing privileges — and this time, providers can be held accountable for the conduct of their owners. Under the new rule, embedded in the 2027 Home Health Prospective Payment System update, the CMS can now act against providers whose parent companies or owners have had licenses suspended, been barred from other federal health programs, or faced legal trouble — closing a long-standing statutory blind spot.
The rule also requires home health agencies, hospices, and medical equipment suppliers to re-enroll as new Medicare providers following a majority ownership change, such as a private equity acquisition. Failure to complete re-accreditation could mean losing Medicare billing rights entirely. Enforcement actions will now be retroactive to the date of initial noncompliance notification.
By the Numbers
Why it matters: With private equity ownership in healthcare surging, regulators have struggled to hold complex ownership structures accountable for fraud. This rule directly targets that gap — signaling a tougher era of Medicare enrollment oversight that could reshape how PE-backed healthcare companies operate.
