Medicare providers and suppliers must report managing employees
All existing Medicare providers and suppliers must report all current managing employees on their Medicare enrollment record to avoid having that enrollment deactivated.
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 of the provider / supplier. These individuals work either under contract or through some other arrangement, whether or not the individual is a W-2 employee of the provider or supplier.
Roles that qualify as managing employees (not an exhaustive list):
- 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
- Other examples include, but are not limited to, a hospice or skilled nursing facility administrator and/or a hospice or skilled nursing facility medical director
- Contact your MAC or NPE if you’re unsure if an individual meets the definition
Updates can be made by:
- Submitting a change of information enrollment application in PECOS
- Mailing a paper application to your Medicare Administrative Contractor (MAC) or DME National Provider Enrollment Contractor (NPE) (PDF)
To learn more, see the Medicare Program Integrity Manual, Chapter 10
Instructions for completing the CMS-855 enrollment applications:
- Completing the Medicare Enrollment Application - Institutional Providers (CMS-855A) application
- Completing the Medicare Enrollment Application - Clinics / Group Practices and Other Suppliers (CMS-855B) application
- Completing the Medicare Enrollment Application - Physicians and Non-Physician Practitioners (CMS-855I) application
- Completing the Medicare Enrollment Application - Medicare Diabetes Prevention Program (MDPP) Suppliers (CMS-20134) application