April 15, 2015

Medicare Enrollment Revalidation Imminent

Medicare Enrollment Revalidation Imminent

Between now and mid-May you may receive a notice requiring you to revalidate your Medicare enrollment – here are the details – if your original enrollment was before March 25, 2011 – get ready – you’ll only have 60 days to react.

Section 6401 (a) of the Affordable Care Act established a requirement for all enrolled providers and suppliers to revalidate their enrollment information under new enrollment screening criteria. This revalidation effort applies to those providers and suppliers that were enrolled prior to March 25, 2011. Newly enrolled providers and suppliers that submitted their enrollment applications to CMS on or after March 25, 2011, are not impacted. Between now and March 23, 2015, MACs 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 the revalidation only after being asked by their MAC to do so. Please note that 42 CFR 424.515(d) provides CMS the authority to conduct these off-cycle revalidations.

Were you sent a revalidation request?
Available in the “Downloads” section is a listing of the providers and suppliers who have been selected to revalidate and should be receiving a revalidation notice from their Medicare contractor within the next 60 days. This list will be updated periodically after new revalidation lists are provided to the MACs.  This is informational only. Providers and suppliers should not take any action to revalidate until asked by their Medicare contractor to do so.  Also available in the “Downloads” section is a listing of all providers and suppliers who have been mailed a revalidation notice. The files are broken down by the month in which the revalidation request was mailed. CMS will add lists on a bimonthly basis. If you are listed, and have not received the request, please contact your Medicare contractor. Their contact information can be found in the Downloads section below. 

Would you like to learn more?
In the “Related Links Inside CMS” section below you will find the transcript of the October 27, 2011 National Provider Call about the Revalidation of Medicare Enrollment. You will also find helpful articles about the revalidation process, enrollment provisions of the Affordable Care Act and how to pay your enrollment application fee.

Still have questions?
Questions concerning provider enrollment policy or your provider’s situation should be referred to your MAC. Their contact information can be found in the “Downloads” section below. Questions concerning a system issue regarding PECOS  should be referred to the CMS EUS Help Desk at 1-866-484-8049, or send an e-mail to [email protected].


Source: CMS

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