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

CMS-1403-FC
2. Medicare Billing Privileges and Existing Tax
Delinquency
The Government Accountability Office (GAO) found that
over 21,000 of the physicians, health professionals, and
suppliers paid under Medicare Part B during the first
9 months of CY 2005 had tax debts totaling over $1 billion.
The GAO report titled, “Medicare, Thousands of Medicare
Part B Providers Abuse the Federal Tax System (GAO-07-
587T)” found abusive and potentially criminal activity,
including failure to remit to IRS individual income taxes
or payroll taxes or both withheld from their employees.
While we do not currently consider whether an
individual physician, NPP currently enrolled in the
Medicare program has delinquent tax debts with the Internal
Revenue Service (IRS), we do consider whether a physician
or NPP was convicted of a Federal or State felony offense,
including income tax evasion, that we have determined to be
detrimental to the best interest of the Medicare program.
Moreover, if a physician or NPP was convicted of Federal or
State felony offense within the 10 years preceding
enrollment or revalidation of enrollment that we determined
to be detrimental to the best interest of the Medicare
program, we could deny or revoke the Medicare billing
privileges of the physician or NPP.
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