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 ...
CMS-1403-FC Response: We are not adopting this recommendation. Instead, we will respond to the specific comments received in response to our specific proposals. Comment: Several commenters requested that we make no revisions to current physician and NPP enrollment rules at this time. Response: We are not adopting this recommendation. Instead, we will respond to the specific comments received in response to our specific proposals. After reviewing public comments, we are finalizing the provisions found at §424.535(h) (formerly §424.535(g)) that require a revoked physician organization, a physician, a NPP, or an IDTF to submit all outstanding claims not previously submitted within 60 calendar days of the revocation effective date. Since IDTFs are already afforded approximately 30 days notification before the effective date of revocation (except for revocations identified in §405.874(b)(2) and §424.535(f) of this final rule), we believe that almost 90 days is more than sufficient time to file any outstanding claims. In addition, we are finalizing the provisions found at §424.44(a) related to the requirements for the timely filing of claims. The timely filing requirements in §424.44(a)(1) and (a)(2) will no longer apply to physician 222
CMS-1403-FC and NPP organizations, physicians, NPPs or IDTFs. We revised this provision so that it is consistent with §424.521 which limits the ability of these suppliers to bill Medicare retrospectively. J. Physician and Nonphysician Practitioner (NPP) Enrollment Issues 1. Effective Date of Medicare Billing Privileges In accordance with §424.510, physician and NPP organizations (that is, groups, clinics, and sole owners) and individual practitioners including physicians and NPPs, operating as sole proprietorships or reassigning their benefits to a physician and nonphysician organization may submit claims as specified in §424.44 after they are enrolled in the Medicare program. This provision permits newly enrolled physician and NPP organizations and individual practitioners, as well as existing physicians and nonphysician organizations and individual practitioners to submit claims for services that were furnished prior to the date of filing or the date the applicant received billing privileges to participate in the Medicare program. For the purposes of this final rule with comment period, we believe that an NPP includes, but is not limited to, the following individuals: anesthesiology assistants, audiologists, certified nurse midwives, certified 223
- Page 171 and 172: CMS-1403-FC After removing the enro
- Page 173 and 174: CMS-1403-FC For CY 2009, we propose
- Page 175 and 176: CMS-1403-FC plain language over pol
- Page 177 and 178: CMS-1403-FC four quarters of ASP pr
- Page 179 and 180: CMS-1403-FC composite rates. The wa
- Page 181 and 182: CMS-1403-FC from the figure in the
- Page 183 and 184: CMS-1403-FC that our goal is the ev
- Page 185 and 186: CMS-1403-FC the average wage index
- Page 187 and 188: CMS-1403-FC Labor Statistics, to de
- Page 189 and 190: CMS-1403-FC been previously deemed
- Page 191 and 192: CMS-1403-FC CBSA where the campuses
- Page 193 and 194: CMS-1403-FC composite rates during
- Page 195 and 196: CMS-1403-FC target amount of compos
- Page 197 and 198: CMS-1403-FC admission. That is, the
- Page 199 and 200: CMS-1403-FC that CMS consider issue
- Page 201 and 202: CMS-1403-FC hold the provider in wh
- Page 203 and 204: CMS-1403-FC Comment: Commenters rai
- Page 205 and 206: CMS-1403-FC who have enrolled in th
- Page 207 and 208: CMS-1403-FC ● Posting IDTF standa
- Page 209 and 210: CMS-1403-FC other diagnostic testin
- Page 211 and 212: CMS-1403-FC entities furnishing mob
- Page 213 and 214: CMS-1403-FC state Radioactive Mater
- Page 215 and 216: CMS-1403-FC equipment and provide t
- Page 217 and 218: CMS-1403-FC Response: We understand
- Page 219 and 220: CMS-1403-FC believe that requiring
- Page 221: CMS-1403-FC these claims will ensur
- Page 225 and 226: CMS-1403-FC prior to their enrollin
- Page 227 and 228: CMS-1403-FC The date of approval is
- Page 229 and 230: CMS-1403-FC organizations, and indi
- Page 231 and 232: CMS-1403-FC To assist physician and
- Page 233 and 234: CMS-1403-FC Comment: Several commen
- Page 235 and 236: CMS-1403-FC date of filing and circ
- Page 237 and 238: CMS-1403-FC services are complying
- Page 239 and 240: CMS-1403-FC days when a Presidentia
- Page 241 and 242: CMS-1403-FC effective date under ap
- Page 243 and 244: CMS-1403-FC Comment: The suggestion
- Page 245 and 246: CMS-1403-FC Response: We thank the
- Page 247 and 248: CMS-1403-FC provider enrollment giv
- Page 249 and 250: CMS-1403-FC instead, it will force
- Page 251 and 252: CMS-1403-FC Response: As stated abo
- Page 253 and 254: CMS-1403-FC Comment: One commenter
- Page 255 and 256: CMS-1403-FC In an attempt to ensure
- Page 257 and 258: CMS-1403-FC rule, rather than limit
- Page 259 and 260: CMS-1403-FC changes have occurred,
- Page 261 and 262: CMS-1403-FC Response: While we moni
- Page 263 and 264: CMS-1403-FC records faster and more
- Page 265 and 266: CMS-1403-FC In §424.521(a)(1), we
- Page 267 and 268: CMS-1403-FC practitioners with the
- Page 269 and 270: CMS-1403-FC In June 2002 and Novemb
- Page 271 and 272: CMS-1403-FC full implementation sch
<strong>CMS</strong>-1403-FC<br />
Response: We are not adopting this recommendation.<br />
Instead, we will respond to the specific comments received<br />
in response to our specific proposals.<br />
Comment: Several commenters requested that we make no<br />
revisions to current physician and NPP enrollment rules at<br />
this time.<br />
Response: We are not adopting this recommendation.<br />
Instead, we will respond to the specific comments received<br />
in response to our specific proposals.<br />
After reviewing public comments, we are finalizing the<br />
provisions found at §424.535(h) (formerly §424.535(g)) that<br />
require a revoked physician organization, a physician, a<br />
NPP, or an IDTF to submit all outstanding claims not<br />
previously <strong>submitted</strong> within 60 calendar days of the<br />
revocation effective date. Since IDTFs are already<br />
afforded approximately 30 days notification before the<br />
effective date of revocation (except for revocations<br />
identified in §405.874(b)(2) and §424.535(f) of this final<br />
rule), we believe that almost 90 days is more than<br />
sufficient time to file any outstanding claims.<br />
In addition, we are finalizing the provisions found at<br />
§424.44(a) related to the requirements for the timely<br />
filing of claims. The timely filing requirements in<br />
§424.44(a)(1) and (a)(2) will no longer apply to physician<br />
222