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DME MAC A News for August 11, 2011 - Medicare Providers Must Begin to Revalidate Enrollment By March 2013 PDF Print E-mail
NHIC, Corp.

DME MAC A ListServe

For Immediate Release
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

August 11, 2011

Medicare Providers Must Begin to Revalidate Enrollment By March 2013
(CMS Message 201108-19)

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
[http://r20.rs6.net/tn.jsp?llr=wd5rpvbab&et=1107062389914&s=1237&e=001QgUa_WJzdt7xWPX6u36nGMDEc-yxYlIN3nTLQpsh7yZGMcRFsBYoIhdeS9afdZ-XNC790pv0rgzcPpAx4CVHy9K_CCHhB1460H8SIFcAbRgUSweTVqcyJA==].

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://r20.rs6.net/tn.jsp?llr=wd5rpvbab&et=1107062389914&s=1237&e=001QgUa_WJzdt7x1TSQ_G2LlmxVGhf8-VIU7xvLA3bldC7cLegQWSwbHqKFopidPaeAp8wlf92FJh7LTGAI85qnEgc5OKgIOuziNfMoZ_wo978=].

In order to reduce the burden on the provider, CMS is working to develop innovative
technologies and streamlined enrollment processes - including Internet-based PECOS
[http://r20.rs6.net/tn.jsp?llr=wd5rpvbab&et=1107062389914&s=1237&e=001QgUa_WJzdt6z9qkFcEFnOryr5Qd63y6xcsEfWeY7gq84Q1cqpY5lATSD1ihqQwxK2WQ0dL-UHDyW47iBiqUbxrLy6dkkH4GF03l8XIsH657QAmWkRCQYCQ==].
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 [http://r20.rs6.net/tn.jsp?llr=wd5rpvbab&et=1107062389914&s=1237&e=001QgUa_WJzdt6b2guKos3AuQindsPXnXTW-EbuSNOfbno5EbpjK-phMazOwaj-0zSp27rILFA2JG-nABsVd3cNlWOmzjU727X-KLgW5kPsVtn2gbR7H8xdJH5aGqdQND7K3MB7T4StVQiaR0X9fZ51owVPnXRpYajjmPOr-2c1qhs=],
titled "Further Details on the Revalidation of Provider Enrollment Information."

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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