Recently, the Centers for Medicare and Medicaid Services (CMS) issued a new regulation regarding the verification of legal status of foreign-born healthcare professionals. The new regulation states:

“If a newly-enrolling physician or non-physician practitioner indicates in Section 2 of his/her Medicare enrollment application (CMS-855I or Internet-based PECOS) that he/she was born in a foreign country, the contractor shall verify that the physician or non-physician practitioner is: (1) a United States citizen; (2) a legal resident of the United States, or (3) otherwise legally authorized to work in the United States. The purpose of this change request is to help ensure that all enrolling physicians and non-physician practitioners are legally authorized to perform Medicare services.”

For the actual CMS Manual System Transmittal, you can view the document here: http://www2.cms.hhs.gov/transmittals/downloads/R323PI.pdf

What does this mean to hospitals and other healthcare organizations?  This new regulation means that the Medicare Fiscal Intermediaries, Carriers and Medicare Administrative Contractors (MACs) must verify the legalized status of a newly enrolled foreign-born physician or non-physician practitioner.  The change DOES NOT apply to healthcare organizations that accept Medicare or Medicaid payment for services.

I am aware that consultants are leaving the key phrase regarding the new Medicare regulation’s reach by omitting to mention it only covers fiscal intermediaries, carriers and MACs.  Healthcare organizations may voluntarily add this verification, but there is no requirement to verify national citizenship of any medical staff member by CMS, or by extension, the Joint Commission.

If you are concerned about these new regulations' effect on your organization, you should contact your corporate legal counsel for an interpretation of this Medicare contractor change. 

The Medicare regulation will become effective on March 29, 2010.

One more Rumor Quashed: the Federal Acquisition Regulation (FAR)

Effective September 8, 2009 the US Department of Homeland Security issued a regulation that all federal contractors use the E-Verify system, a federal government databases to verify workers’ employment eligibility. Physicians and other healthcare entities that provide patient care services are not subject to this requirement unless they elect to contract with a federal agency or are federal prime contractors in any other capacity.  One example is health care providers and pharmaceutical and medical device manufacturers who have a Federal government contract containing the E-Verify clause, which requires the usage E-Verify with employees working on the Federal contract. Those providers will be required to use E-Verify with all new employees and with any employees assigned to work on the Federal contract. A provider will only be required to use E-Verify with employees assigned to a Federal contract when there is a separate contract with a Federal agency to provide specific health care items (i.e. pharmaceuticals or devices) or specific services delivered through a Government-sponsored health plan.  An important exception exists in this regulation for health care providers only having an agreement with Medicare to provide patient services. In those situations the usage of E-Verify is not required.

March 18, 2010