September 26, 2008
Incorporation of regulatory revisions into Chapter 10 of the Program Integrity Manual
Effective Date: October 1, 2008
Implementation Date: October 6, 2008
Summary
This manual update incorporates non-appeals related provisions contained in “Appeals of CMS or CMS Contractor Determinations When a Provider or Supplier Fails to Meet the Requirements for Medicare Billing Privileges (CMS 6003-F)” which was published in the Federal Register on June 27, 2008.
In this change request, contractors are instructed to do the following:
• Establish an enrollment bar for those providers and suppliers whose billing privileges are revoked.
• Require providers and suppliers to receive payments by electronic funds transfer (EFT) when enrolling.
• Allow Medicare contractors to reject an enrollment application when a provider or supplier fails to provide missing information/documentation within 30 days of a contractor’s request for additional information.
Additional information is available on the CMS Web site. Here is the link to the MLN Matters article MM6178
.
Source: CMS MLN Matters Article MM6178

