(304) 241-1261 contact@healthgroup.com

 Volume 23.08

CMS has announced a $709 calendar year application fee for providers that are:

  • Initially enrolling in the Medicare program, Medicaid program, or the Children’s Health Insurance Program (“CHIP”),
  • Revalidating their Medicare, Medicaid, or CHIP enrollment, or
  • Adding a new Medicare practice location.

The fee is required for enrollment applications submitted on or after January 1, 2024, and on or before December 31, 2024.  Additional information is available here.


The Office of Management and Budget recently approved a revised Form CMS-855A (Medicare enrollment) to include more ownership information and other changes.  The revised form is being accepted starting on November 17, 2023; however, the prior version is still being accepted through December 17, 2023.  After December 17, 2023, the Medicare Administrative Contractor (“MAC”) will return any submission on the old form to the provider and notify the provider that the new version must be submitted.  The new version is available here.

The changes are largely the result of provisions included in Final Rule CMS-6084-F: Medicare and Medicaid Programs: Disclosure of Ownership and Additional Disclosable Parties for Skilled Nursing Facilities and Nursing Facilities; Medicare Providers’ and Suppliers” Disclosure of Private Equity Companies and Real Estate Investment Trusts.  Additional modifications to Form CMS-855A are anticipated because of numerous integrity measures finalized by CMS.


CMS is now accepting applications for the Guiding an Improved Dementia Experience (“GUIDE”) Model.  The GUIDE Model will focus on dementia care management and aims to improve quality of life for people living with dementia, reduce strain on their unpaid caregivers, and enable people living with dementia to remain in their home and communities.  The program is intended to provide a comprehensive package of care coordination and management, caregiver education and support, and respite services.

Through the GUIDE Model, CMS will test an alternative payment for participants that deliver key supportive services to people with dementia, including comprehensive, person-centered assessments and care plans, care coordination, and 24/7 access to a support line. Under the model, participants will assign people with dementia and their caregivers to a care navigator who will help them access services and supports, including clinical services and non-clinical services such as meals and transportation through community-based organizations.

Additional details are available here and here.