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

CMS-1403-FC
faith reduces the time available for appeal and then locks
the physician out of Medicare for at least a year.
Response: We disagree with this commenter. Whenever
a physician or NPP’s State medical license is suspended or
revoked, is convicted of felony as described in
§424.535(a)(3), excluded or debarred from participating the
Federal exclusion or debarment, or is determined by CMS or
our contractor not to be operational, we believe that the
payments to these practitioners should immediately cease.
Comment: One commenter suggested, at the very least,
current rights of appeal should be preserved for all
proposed denials and we should actively research the
performance of its contractors in auditing clinicians who
make “all or substantially all of their clinical encounters
in the patient’s home,” and give provider feedback a
defined role in the evaluation and subsequent award of
contracts to intermediaries.
Response: This comment is outside the scope of this
proposed rule and can not be addressed in this final rule.
After reviewing public comments, we are finalizing
§405.874(b)(2) to state “The revocation of a provider’s or
supplier’s billing privileges is effective 30 days after
CMS or the CMS contractor mails notice of its determination
to the provider or supplier, except if the revocation is
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