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

CMS-1403-FC
identification number (TIN), reassigning benefits to
another entity, or by submitting an enrollment application
as another provider or supplier type even though the entity
for which the provider or supplier furnished services and
has had its billing privileges revoked, suspended, or has
an outstanding Medicare overpayment. Absent a reason to
reject or deny a Medicare enrollment application, the
Medicare FFS contractor is required to approve the
enrollment application for a provider or supplier who meets
all other Federal and State enrollment requirements for
their provider or supplier type.
By submitting and having an enrollment application
(for example, an initial application or a change of
ownership) with a new TIN, some physician and NPP
organizations and individual practitioners are able to
circumvent existing Medicare revocation, payment
suspension, overpayment recovery, and medical review
processes by obtaining additional Medicare billing
privileges. By obtaining additional billing privileges for
multiple locations, these providers and suppliers are able
to discontinue the use of the NPI that has an
administrative action against it and bill and receive
payment under another NPI.
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