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 recognize that we have published several regulations within the last 3 years and a number of program integrity manual instructions designed to strengthen the enrollment process. However, we continue to believe that CMS must maintain the flexibility to issue regulations in accordance with the Administrative Procedures Act. Comment: One commenter urged CMS to clarify the apparent inconsistent policies on revalidation as set forth in the April 21, 2006 provider enrollment rule titled, “Medicare Program: Requirements for Providers and Suppliers to Establish and Maintain Medicare Enrollment (CMS-6002-F)” and the June 27, 2008 provider enrollment rule titled, “Medicare Program: Appeals of CMS or CMS Contractor Determinations When a Provider or Supplier Fails to Meet the Requirements for Medicare Billing Privileges (CMS-6003-F).” Response: In response to comment in the April 21, 2006 final rule (71 FR 20754), we stated, “We expect that a fee-for-service contractor would notify the provider or supplier in writing regarding the need to revalidate its enrollment information. Once notified, providers and suppliers would be expected to review, update, and submit any changes and supporting documentation regarding the enrollment record within 60 days. If no 258
CMS-1403-FC changes have occurred, a provider or supplier would simply sign, date, and return the revalidation application.” In addition, we stated in the provisions of the final rule that, “We will contact all providers and suppliers directly as to when their 5-year revalidation cycle starts beginning with those providers and suppliers currently enrolled in the Medicare program but that have not submitted a completed enrollment application. The revalidation process would ensure that we collect and maintain complete and current information on all Medicare providers and suppliers and ensure continued compliance with Medicare requirements. In addition, this process further ensures that Medicare beneficiaries are receiving items or services furnished only by legitimate providers and suppliers, and strengthens our ability to protect the Medicare Trust Funds.” In response to a comment in the June 27, 2008 final rule (73 FR 36448), we stated, “Therefore, providers and suppliers that enrolled in the Medicare program prior to 2003, but who have not completed a Medicare enrollment application since then, have had more than 2 years to come into voluntary compliance with our enrollment criteria by submitting a complete enrollment application. With this final rule, we are again notifying physicians, providers, and suppliers that they may voluntarily complete and submit 259
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<strong>CMS</strong>-1403-FC<br />
changes have occurred, a provider or supplier would simply<br />
sign, date, and return the revalidation application.” In<br />
addition, we stated in the provisions of the final rule<br />
that, “We will contact all providers and suppliers directly<br />
as to when their 5-year revalidation cycle starts beginning<br />
with those providers and suppliers currently enrolled in<br />
the Medicare program but that have not <strong>submitted</strong> a<br />
completed enrollment application. The revalidation process<br />
would ensure that we collect and maintain complete and<br />
current information on all Medicare providers and suppliers<br />
and ensure continued compliance with Medicare requirements.<br />
In addition, this process further ensures that Medicare<br />
beneficiaries are receiving items or services furnished<br />
only by legitimate providers and suppliers, and strengthens<br />
our ability to protect the Medicare Trust Funds.”<br />
In response to a comment in the June 27, 2008 final<br />
rule (73 FR 36448), we stated, “Therefore, providers and<br />
suppliers that enrolled in the Medicare program prior to<br />
2003, but who have not completed a Medicare enrollment<br />
application since then, have had more than 2 years to come<br />
into voluntary compliance with our enrollment criteria by<br />
submitting a complete enrollment application. With this<br />
final rule, we are again notifying physicians, providers,<br />
and suppliers that they may voluntarily complete and submit<br />
259