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Notice: This CMS-approved document has been submitted - Philips ...

Notice: This CMS-approved document has been submitted - Philips ... Notice: This CMS-approved document has been submitted - Philips ...

healthcare.philips.com
from healthcare.philips.com More from this publisher
19.02.2013 Views

CMS-1403-FC We believe that the provisions regarding physicians, NPPs, and physician and NPP organizations as discussed in section II.J. of this final rule with comment period will have minimal budgetary impact. The provisions of this final rule supplement, but do not replace or nullify, existing regulations concerning the issuance of physician and NPP billing privileges, and payment for Medicare covered items or services to eligible physicians and NPPs. We have already increased our efforts to seek more uniformity in the enrollment process. However, our experience clearly shows that the best means for preventing payment errors and, in worst cases, abuse by providers and suppliers, is to discourage and prevent their entry into the Medicare program. While some individuals and organizations may perceive our requirements as a barrier to their access to serving Medicare beneficiaries, we do not believe that bona fide physicians, NPP, or physician or NPP organizations will experience any difficulty in obtaining or maintaining Medicare billing privileges. We expect this final rule with comment period to ensure that the Medicare program has adequate information on those who seek to bill the program for items or services. The primary goal of this provision of the final rule with comment period, through standard enrollment 1060

CMS-1403-FC requirements is to allow us to collect and maintain (keep current) a unique and equal data set on all current and future physicians, NPPs, and physician and NPP organizations that are billing or will bill the Medicare program for items or services furnished to Medicare beneficiaries. By achieving this goal, we will be better positioned to protect the Medicare Trust Funds and the Medicare beneficiaries. This rule will also allow us to develop, implement, and enforce national enrollment procedures to be administered uniformly by all Medicare contractors. Further, we believe that the enrollment provisions contained in this rule are necessary to ensure that beneficiaries receive quality care by making certain that the physicians, NPPs, and physician or NPP organizations providing care meet established standards and are enrolled in the Medicare program. As a result of currently not having quantifiable data, we cannot effectively derive an estimate of the monetary impacts of these provisions. Accordingly, we sought public comment so that the public may provide any data available that provides a calculable impact or any alternative to the proposed provision. However, no further data was presented by the public in order to provide a calculable impact. We 1061

<strong>CMS</strong>-1403-FC<br />

requirements is to allow us to collect and maintain (keep<br />

current) a unique and equal data set on all current and<br />

future physicians, NPPs, and physician and NPP<br />

organizations that are billing or will bill the Medicare<br />

program for items or services furnished to Medicare<br />

beneficiaries. By achieving this goal, we will be better<br />

positioned to protect the Medicare Trust Funds and the<br />

Medicare beneficiaries.<br />

<strong>This</strong> rule will also allow us to develop, implement,<br />

and enforce national enrollment procedures to be<br />

administered uniformly by all Medicare contractors.<br />

Further, we believe that the enrollment provisions<br />

contained in this rule are necessary to ensure that<br />

beneficiaries receive quality care by making certain that<br />

the physicians, NPPs, and physician or NPP organizations<br />

providing care meet established standards and are enrolled<br />

in the Medicare program.<br />

As a result of currently not having quantifiable data,<br />

we cannot effectively derive an estimate of the monetary<br />

impacts of these provisions. Accordingly, we sought public<br />

comment so that the public may provide any data available<br />

that provides a calculable impact or any alternative to the<br />

proposed provision. However, no further data was presented<br />

by the public in order to provide a calculable impact. We<br />

1061

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