Rule Sets New Enrollment Requirements for Medicare Suppliers

BALTIMORE–In an effort to curb fraud and abuse, CMS has issued
new enrollment requirements for Medicare providers and
suppliers.

A final rule issued last week requires that all health care
providers and suppliers fill out an enrollment form and
periodically update and certify the accuracy of their enrollment
information to receive and maintain billing privileges in the
Medicare program.

“Basically, this final rule consolidates current regulations
found throughout the Code of Federal Regulations and more
clearly defines what Medicare expects from providers and suppliers
furnishing items or rendering services to the Medicare
beneficiaries,” the agency said in the rule, which takes effect
June 20.

In one change from the proposed rule, which was published in
April 2003, the three-year cycle for revalidation was upped to five
years. The agency said it agreed with comments that a longer cycle
would reduce the burden on providers.

Some commenters recommended that the agency not perform
unannounced site visits to verify enrollment information, but CMS
kept this requirement, explaining that they are a “useful tool.”
The agency also rejected a request to implement a grandfather
process for providers who already have billing numbers.

To view the rule, published in Friday’s Federal Register,

click here.