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

CMS-1403-FC
Specifically, §424.515 states that a provider or
supplier (other than a DMEPOS supplier), must resubmit and
recertify the accuracy of its enrollment information every
5 years. Therefore, physicians, NPPs and physician and
NPP organizations 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.
To date, approximately 80 percent of the enrolled
physicians and 98 percent of NPPs have updated their
Medicare enrollment record within the last 5 years.
To ensure that Medicare only pays eligible physicians
and NPPs, we are again notifying physicians and NPPs that
they may voluntarily complete and submit a Medicare
enrollment application and the necessary supporting
documentation prior to our formal request for revalidation.
In accordance with the existing provision at
§424.535(a)(1)(ii), providers and suppliers who choose not
to come into voluntary compliance or fail to respond to a
revalidation request within 60 days of the Medicare
contractor’s request may be subject to the revocation of
their billing privileges.
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