US Medicare Provider and Supplier Enrollment (42 CFR Part 424 Subpart P) 424.519: On CMS request, disclose every current and prior 5-year affiliation of the organisation or its owners and managing employees with a provider or supplier that has a disclosable event, with the required identifying and relationship details

What does 424.519 require?

On a CMS request, made when CMS has determined that the applicant or revalidating provider may have at least one such affiliation, the provider or supplier must disclose any and all affiliations that it, or any of its owning or managing employees or organisations, has or within the previous 5 years had with a currently or formerly enrolled Medicare, Medicaid or CHIP provider or supplier that has a disclosable event (uncollected debt of which notice was sent, including civil money penalties and assessments; a payment suspension; an OIG exclusion; or a denial, revocation or termination, including voluntary termination to avoid one). For each affiliation it must give the affiliate's legal name, doing-business-as name, TIN and NPI, the reason for disclosure, the length, type and degree of the relationship, and the reason any ended, via the Form CMS-855 or PECOS; data already reported in the owning or managing control section need not be repeated. Failure to disclose what the provider knew or should have known may lead to denial or revocation, and CMS may deny or revoke where it determines an affiliation (disclosed or not) poses an undue risk of fraud, waste or abuse, weighing the duration, currency, degree and end of the affiliation and the type, timing, amount and reason of the disclosable event.