Health Care Law Blog

Medicare Provider-Supplier Revalidation: Are You Ready?

All providers and suppliers that were enrolled with the Medicare program prior to March 25, 2011 will be asked to revalidate their enrollment information in the near future.  According to a statement issued by the Department of Health and Human Services' Centers for Medicare and Medicaid Services ("CMS"), intermediaries will begin contacting providers and suppliers to do the following:

1. Update the provider/supplier's enrollment through the internet-based Provider Enrollment, Chain and Ownership System ("PECOS") or complete the CMS 855 Form;
2. Sign the certification statement on the application;
3. If applicable, pay a fee through Pay.gov; and
4. Mail the supporting documents and certification statement to the intermediary.

Such action is required by Section 6401(a) of the Patient Protection and Affordable Care Act. Newly enrolled providers and suppliers that submitted enrollment applications to CMS on or after March 25, 2011 will not be impacted by this rule. 

CMS advises that between now and March 23, 2013, intermediaries will send out notices on a regular basis to begin the revalidation process for each provider and supplier.  Providers and suppliers must wait to submit their revalidation until after being asked to do so by the intermediary. 

For more information, providers and suppliers should review the CMS MLN Matters transmittal, or contact one of Foster Swift's health care law attorneys.

Categories: Billing/Payment, Health Care Reform, Hospitals, Medicare/Medicaid, Physicians

Posted by: Jennifer Kildea Dewane