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

CMS-1403-FC
privileges and assess any applicable overpayment for the
difference in payment rates retroactive to the date the
change in practice location occurred. We believe that the
authority to revoke billing privileges has already been
established in §424.535(a)(5)(ii).
We are finalizing the provision at proposed
§424.535(a)(9) which would specify that failure to comply
with the reporting requirements specified in §424.516(d)
would be a basis for revocation. Additionally, we are also
finalizing the provision we proposed in §424.565(a),
“Failure to comply with the reporting requirements
specified in §424.516(d) would result in a Medicare
overpayment from the date of a final adverse action or a
change in practice location.” In this situation, an
overpayment for failure to timely report these changes
would be calculated back to the date of the final adverse
action or the date of the change in practice location.
Once an overpayment has been assessed, we will follow the
overpayment regulations established at 42 CFR Part 405
subpart C.
Based on public comments, we are adding a definition
of final adverse action to §424.502(a). A final adverse
action means one or more of the following actions: (1) A
Medicare-imposed revocation of any Medicare billing
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