Volume 25.03
On March 27, 2025, the U.S. Department of Health and Human Services (HHS) announced a dramatic restructuring in accordance with President Trump’s Executive Order, “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.”
According to HHS, “the restructuring will address this and serve multiple goals without impacting critical services. First, it will save taxpayers $1.8 billion per year through a reduction in workforce of about 10,000 full-time employees who are part of this most recent transformation. When combined with HHS’ other efforts, including early retirement and Fork in the Road, the restructuring results in a total downsizing from 82,000 to 62,000 full-time employees.
Secondly, it will streamline the functions of the Department. Currently, the 28 divisions of the HHS contain many redundant units. The restructuring plan will consolidate them into 15 new divisions, including a new Administration for a Healthy America, or AHA, and will centralize core functions such as Human Resources, Information Technology, Procurement, External Affairs, and Policy. Regional offices will be reduced from 10 to 5.
Third, the overhaul will implement the new HHS priority of ending America’s epidemic of chronic illness by focusing on safe, wholesome food, clean water, and the elimination of environmental toxins. These priorities will be reflected in the reorganization of HHS.
Finally, the restructuring will improve Americans’ experience with HHS by making the agency more responsive and efficient, while ensuring that Medicare, Medicaid, and other essential health services remain intact.”
The Press release can be viewed here.
REPORTING MANAGING EMPLOYEES TO THE MEDICARE PROGRAM
On April 3, 2025, CMS released 2025-04-03-MLNC which includes the following:
“You must report all current managing employees on your Medicare enrollment application, or we may deactivate your enrollment.
You can make updates by:
- Submitting an 855-enrollment application in PECOS
- Mailing a paper application to your Medicare Administrative Contractor (MAC) or DME National Provider Enrollment Contractor (NPE) (PDF)
Managing employees are general managers, business managers, administrators, directors, or other individuals who exercise operational or managerial control or directly or indirectly conduct day-to-day operations.
While not an exhaustive list, these roles qualify as managing employees: Chief Executive Officer, Chief Operating Officer, Chief Financial Officer, Compliance Officer
- Regional Manager, Clinical Manager, Operations Manager, Care Coordination Manager, Location Manager, Administration Manager
- Compliance Director, Clinical Director
Contact your MAC or NPE if you’re unsure if an individual meets the definition.
To learn more, see the Medicare Program Integrity Manual, Chapter 10 (PDF).”
CMS is serious regarding Medicare provider integrity. Make certain to review information on file with the Medicare program to determine if additional individuals need to be reported to the Medicare program. The list of individuals identified above does not include direct and indirect ownership interests which must also be reported.