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

CMS-1403-FC
determines in February 2008 that a physician failed to
notify Medicare about a final adverse action that occurred
on June 30, 2007, that physician may be subject to an
overpayment for all Medicare payments beginning
June 30, 2007 and have their Medicare billing privileges
revoked effective retroactively back to June 30, 2007 as
well.
Additionally, we proposed to add a requirement for
change in location at §424.516(d)(1)(iii). Since a change
in location may impact the amount of payment for services
furnished by placing the physician and NPP organizations
and individual practitioners into a new Core Based
Statistical Area (CBSA). We believe that it is essential
that physician and NPP organizations and individual
practitioners report changes in practice location including
those that impact the amount of payments they receive
within a timely period (that is, 30 days). However, unlike
a final adverse action, which may preclude all payments if
reported, failure to report a change in practice location
may impact the amount of payment, not whether a physician
and NPP organizations and individual practitioners may be
eligible to receive payments. Accordingly, we believe that
failing to report changes in practice location would result
in an overpayment for the difference in payment rates
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