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More Essential Data From CMS

More Essential Data From CMS

The Centers for Medicare & Medicaid Services (CMS) just keep putting out the data, and we want to keep you aware of both the data available about your facility as well as the data about the other entities that impact your facility.

The recent release of ownership data for Medicare-certified hospice and home health agencies is a significant step towards promoting competition and protecting consumers in the healthcare industry. By making this information available to the public, patients and their families will have greater transparency and knowledge about the ownership structure of these agencies, which can ultimately help them make more informed decisions about their care.

Additionally, this move could help uncover potential conflicts of interest or fraudulent activities by healthcare providers. By shining a light on who owns these agencies and how they are structured, regulators and enforcement agencies will have a better understanding of where to focus their efforts in ensuring that patients receive quality care and are not taken advantage of.

Overall, this is a positive development for the healthcare industry and shows the Biden-Harris Administration’s commitment to promoting transparency and competition in all sectors of the economy.

In January CMS released ownership data on essentially all hospitals participating in Medicare in the US.  You can access this data at: https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners

Since January of this year, CMS began offering “Change of Ownership” or CHOW data pulled from the Provider Chain and Enrollment System or “PECOS.”  I will give the web address for those that want to download data: https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-change-of-ownership

The data fields for this data includes:

ENROLLMENT ID – BUYER
ENROLLMENT STATE – BUYER
PROVIDER TYPE CODE – BUYER
PROVIDER TYPE TEXT – BUYER
NPI – BUYER
MULTIPLE NPI FLAG – BUYER
CCN – BUYER
ASSOCIATE ID – BUYER
ORGANIZATION NAME – BUYER
DOING BUSINESS AS NAME – BUYER
CHOW TYPE CODE
CHOW TYPE TEXT
EFFECTIVE DATE
ENROLLMENT ID – SELLER
ENROLLMENT STATE – SELLER
PROVIDER TYPE CODE – SELLER
PROVIDER TYPE TEXT – SELLER
NPI – SELLER
MULTIPLE NPI FLAG – SELLER
CCN – SELLER
ASSOCIATE ID – SELLER
ORGANIZATION NAME – SELLER
DOING BUSINESS AS NAME – SELLER

Also just released in April for Nursing home CHOWS you can pull down data using the following link:

https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/skilled-nursing-facility-change-of-ownership/data

We are considering both webinars and other materials to help providers and other people in healthcare find public data, stay tuned!

Programming note: Listen to Timothy Powell every Tuesday when he anchors the Talk Ten Tuesdays News Desk, 10 Eastern.

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Timothy Powell, CPA, CHCP

Timothy Powell is a nationally recognized expert on regulatory matters, including the False Claims Act, Zone Program Integrity Contractor (ZPIC) audits, and U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) compliance. He is a member of the RACmonitor editorial board and a national correspondent for Monitor Mondays.

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