The rule targets providers owned by companies with violations in other programs and requires reenrollment for home health and hospice providers following a major ownership change.

The Trump administration has prioritized rooting out what it says is fraud, waste and abuse in federal healthcare programs, including creating several multi-agency groups to fight fraud and deferring billions of dollars in Medicaid payments to a handful of states accused of lackluster enforcement.

Regulators say the latest final rule builds on the administration's efforts by giving the CMS greater authority to bar providers that pose a high risk to Medicare's payment integrity, specifically addressing the rise of profit-maximizing companies.

The CMS will now be able to deny or revoke Medicare enrollment due to violations committed by a company’s owners or parent companies, whereas the agency could only boot providers for their own violations. This includes whether they have had their license suspended or revoked in another state, or whether another federal healthcare program has suspended them.

Additionally, any actions taken against providers will now be retroactive to when the CMS or its contractors notify providers of noncompliance.

Increasing rates of private equity ownership in healthcare have drawn intense scrutiny from federal and state enforcers over their profit-seeking missions, which some argue has incentivized and exacerbated fraud, waste and abuse across the industry.

Regulators have said statutory blind spots have limited their ability to identify and stop fraud as ownership changes accelerated over the last decade.

The rule also ramped up fraud enforcement for home health agencies, hospices and medical equipment suppliers, requiring them to re-enroll as new providers with Medicare when they undergo a change in majority ownership, such as an acquisition by a private equity firm.

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