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<strong>CMS</strong>-1403-FC<br />

Response: We disagree with this commenter. As stated<br />

above, we believe reporting changes in ownership, final<br />

adverse actions, and changes in practice locations are<br />

essential to ensuring that the Medicare program makes<br />

correct payments to eligible practitioners and<br />

organizations. We also believe that it is essential that<br />

physicians and NPPs maintain ordering and referring<br />

<strong>document</strong>ation to support the claims submissions.<br />

Comment: One commenter stated that levying an<br />

overpayment for failure to report a “reportable event,”<br />

within 30 days is excessive for what is likely an honest<br />

oversight.<br />

Response: We disagree with this commenter that<br />

establishing an overpayment is excessive when a physician,<br />

NPP or physician and NPP organization fails to report a<br />

final adverse action, such as a State license suspension or<br />

revocation or adverse legal action, that may preclude<br />

participation in the continued participation in the<br />

Medicare program in a timely manner (that is, 30 days).<br />

Comment: One commenter stated that Federal regulations<br />

regarding overpayments are already established at 42 CFR<br />

part 405, therefore, changing the provider enrollment<br />

requirements to prevent overpayments is not necessary.<br />

304

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