New Medicare enrollment requirements for medical providers and suppliers may post serious billing issues if applications are not filled out properly and timely.
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| [amberusa.com] |
Section 6401 (a) of the Affordable Care Act established a requirement for all Medicare-enrolled providers and suppliers to revalidate their enrollment information under new enrollment screening criteria. This revalidation effort applies to those providers and suppliers that were enrolled prior to March 25, 2011. Newly enrolled providers and suppliers that submitted their enrollment applications to CMS on or after March 25, 2011, are not impacted.
One Kansas health department suffers the consequences of an untimely revalidation application. The Lawrence-Douglas County health department is currently unable to bill Medicare for healthcare services it provides to seniors. This self-proclaimed "personnel issue" has already cost the department upwards of $6,000.
Between now and March 23, 2015, MACs will send out notices on a regular basis to begin the revalidation process for each provider and supplier. Providers and suppliers must wait to submit the revalidation only after being asked by their Medicare Administrative Contractor (MAC) to do so. Please note that 42 CFR 424.515(d), part of the rules issued by CMS under its rulemaking authority, provides CMS the authority to conduct these off-cycle revalidations.
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