Lisa Re Discusses CMS Revocation and Exclusion Authority with Law360

Lisa Re, Arnold & Porter Life Sciences & Healthcare Regulatory partner and former Assistant Inspector General for Legal Affairs at the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG), was quoted in the recent Law360 article, “Rule Gives Power To Oust Medicare Providers: What To Know,” discussing the Centers for Medicare & Medicaid Services’ (CMS) expanded authority to revoke providers’ Medicare billing privileges under the 2027 Home Health Prospective Payment System final rule.

Lisa explained that revocation and exclusion are separate authorities that CMS can now use together, allowing it to remove a provider from other federal healthcare programs after revoking Medicare billing privileges. “Without that exclusion authority, what would have happened historically is CMS may have referred a revocation over to OIG for them to consider for exclusion, but they don’t have to do any of that now,” she said.

On the rule’s affiliation provisions, which let CMS revoke enrollment based on risks posed by a provider’s owners, managing employees, or related organizations, Lisa noted that the government kept broad authority despite public concern. “The government wants to have the broadest possible authority, so that if it identifies patterns and practices within a particular company or entity or common ownership ... as potentially problematic, it wants that broad authority so that it can take action to protect federal programs,” she said.

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