Description

This webinar will describe thes significant changes and provide a practical, primary-source analysis of what is already in effect, what takes effect January 1, 2027, and what is coming in the final and proposed. Whether you are managing compliance risk, structuring a transaction, running a billing operation, or advising providers, the stakes of not knowing about these enforcement initiatives and final and proposed rules have never been higher.

Attendees will leave with a clear picture of CMS’s current enforcement priorities, the provider types drawing the most scrutiny, the enrollment changes that are coming down the pike, and the payment rule changes that will directly affect revenue in 2027. If your organization bills Medicare, employs or contracts with Medicare providers, or operates in any high-risk sector named by CMS, this webinar is essential.

Areas Covered in the Session:-

• The CRUSH Initiative: CMS’s Most Aggressive Fraud Enforcement Overhaul in Years
  • CMS’s February 2026 Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) Request for Information signals sweeping proposed changes to enrollment safeguards, identity proofing, ownership disclosure, payment suspension authority, and AI-assisted billing oversight — across Medicare, Medicaid, CHIP, and the Marketplace. A proposed rule is expected before year-end.
• Enrollment Moratoria: Three Nationwide Freezes and What Comes After
  • Active 2026 moratoria blocked new Medicare enrollments for DMEPOS suppliers (since February), home health agencies, and hospices (May 13 — running through at least November 13). Understand what is barred, which applications are grandfathered, how ownership changes trigger re-enrollment risk, and what “high-risk” post-moratorium screening means for new entrants.
• $41.9 Billion in Medicare Savings — And CMS Wants More: Payment Suspensions and new Enrollent Rules
  • CMS suspended over $2.1 billion in payments in a single year and is dramatically expanding its use of prepayment suspensions based on “credible allegation of fraud” — before any investigation concludes. It has also been given the power to suspend providers, and it is expected to finalize enrollment rules that are game-changers.
• The Multiagency Enforcement Task Force: DOJ, OIG, CMS, and State AGs Are Coordinating
  • A 2026 Executive Order established a cross-agency fraud task force. With VP Vance letters to all 50 state AGs, congressional Medicaid fraud investigations, and CMS publicly naming California, Florida, Maine, Minnesota, and New York, federal-state enforcement coordination is at its highest level in a decade. Know who is looking and what they are looking for.
• Telehealth Enrollment Just Got Permanent Rules — And They Changed the Game
  • CMS finalized permanent telehealth enrollment flexibilities in August 2026: billing follows the MAC for the state where the provider is physically located, not where patients are. Virtual-only providers must now report home addresses in PECOS. Interstate practitioners face new enrollment obligations. What this means for multi-state and telehealth-only practices.
• High-Risk Sectors Under the Microscope: Hospice, Home Health, Behavioral Health, ABA, DMEPOS, and Labs
  • CMS and OIG have publicly identified their enforcement targets: “churn and burn” hospice schemes, home health certification fraud, genetic/molecular lab billing, ABA therapy, DMEPOS in Medicare Advantage, and AI-assisted coding in hospitals.
• The 2027 IPPS Final Rule and OPPS and PFS Proposed Rues
  • Key changes in all of these rules will be discussed that will significantly impact both operations and finances, including for hospitals participating in the 340B program.

Background:-

The federal healthcare regulatory landscape has shifted dramatically in 2026 — CMS has launched its most aggressive fraud and enrollment enforcement campaign in years, imposing nationwide enrollment freezes on home health, hospice, and DMEPOS, standing up a multiagency fraud task force, and suspending over $2.1 billion in payments through its Fraud Defense Operations Center, all while signaling even broader enforcement authority through the CRUSH initiative.

At the same time, three major CMS payment rules — the FY 2027 IPPS final rule, the CY 2027 OPPS proposed rule, and the CY 2027 Physician Fee Schedule proposed rule — are reshaping hospital inpatient and outpatient payment, slashing 340B reimbursement, overhauling E/M billing, extending telehealth flexibilities, and mandating new participation in value-based payment models.

Who Will Benefit:-

• Healthcare and hospital compliance personnel, legal counsel, and operators (C-Suite, directors)
• Medicare enrollment specialists and revenue cycle directors
• Home health agency, hospice, and DMEPOS operators and their legal/compliance teams
• Telehealth platform operators and telehealth-only practices
• Behavioral health, psychiatric, and mental health practice owners
• Private equity and investment groups with healthcare portfolio companies
• Medical billing companies and third-party billing consultants.