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Medicare Providers Must Begin to Revalidate Enrollment By March 2013

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  • Melinda
    Our taxpayer dollars hard at work... All providers and suppliers who enrolled in the Medicare program prior to Friday, March 25, 2011, will be required to
    Message 1 of 1 , Aug 12, 2011
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      Our taxpayer dollars hard at work...

      All providers and suppliers who enrolled in the Medicare program prior
      to Friday, March 25, 2011, will be required to revalidate their
      enrollment under new risk screening criteria required by the Affordable
      Care Act (section 6401a). (Providers/suppliers who enrolled on or after
      Friday, March 25, 2011 have already been subject to this screening, and
      need not revalidate at this time.)

      In the continued effort to reduce fraud, waste, and abuse, CMS
      implemented new screening criteria to the Medicare provider/supplier
      enrollment process beginning in March 2011. Newly-enrolling and
      revalidating providers and suppliers are placed in one of three
      screening categories - limited, moderate, or high - each representing
      the level of risk to the Medicare program for the particular category of
      provider/supplier, and determining the degree of screening to be
      performed by the Medicare Administrative Contractor (MAC) processing the
      enrollment application.

      Between now and March 2013, MACs will be sending notices to individual
      providers/suppliers; please begin the revalidation process as soon as
      you hear from your MAC. Upon receipt of the revalidation request,
      providers and suppliers have 60 days from the date of the letter to
      submit complete enrollment forms. Failure to submit the enrollment forms
      as requested may result in the deactivation of your Medicare billing
      privileges. The easiest and quickest way to revalidate your enrollment
      information is by using Internet-based PECOS (Provider Enrollment,
      Chain, and Ownership System), at https://pecos.CMS.hhs.gov
      <https://pecos.cms.hhs.gov/> .

      Section 6401a of the Affordable Care Act requires institutional
      providers and suppliers to pay an application fee when enrolling or
      revalidating ("institutional provider" includes any provider or supplier
      that submits a paper Medicare enrollment application using the CMS-855A;
      CMS-855B, NOT including physician and non-physician practitioner
      organizations; CMS-855S; or associated Internet-based PECOS enrollment
      applications); these fees may be paid via www.Pay.gov
      <http://www.pay.gov/> .

      In order to reduce the burden on the provider, CMS is working to develop
      innovative technologies and streamlined enrollment processes - including
      Internet-based PECOS at https://pecos.cms.hhs.gov/
      <https://pecos.cms.hhs.gov/> . Updates will continue to be shared with
      the provider community as these efforts progress.

      For more information about provider revalidation, review the Medicare
      Learning Network's Special Edition Article #SE1126 at
      http://www.cms.gov/MLNMattersArticles/downloads/SE1126.pdf
      <http://www.cms.gov/MLNMattersArticles/downloads/SE1126.pdf> , titled
      "Further Details on the Revalidation of Provider Enrollment
      Information."

      Source: LEARNRESOURCE-L E-mail Update, National Institutes of Health,
      U.S. Department of Health and Human Services dated August 10, 2011

      Posted: 8/10/2011
      https://www.noridianmedicare.com/cgi-bin/coranto/viewnews.cgi?id=EFEFpEF\
      lZlhyPVLspX&tmpl=part_b_viewnews&style=part_ab_viewnews
      <https://www.noridianmedicare.com/cgi-bin/coranto/viewnews.cgi?id=EFEFpE\
      FlZlhyPVLspX&tmpl=part_b_viewnews&style=part_ab_viewnews> Melinda
      Brown, CMBS Ins Biller


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