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 (Medicare Administrative Contractors) 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 (Medicare Administrative Contractors) to do so. Please note that 42 CFR 424.515(d) provides CMS the authority to conduct these off-cycle revalidations.
Revalidation of Medicare provider enrollment has been implemented in stages for providers who were enrolled in Medicare prior to March 25, 2011. Audiologists and speech-language pathologists do not need to seek out revalidation, but they do need to respond within 60 days of the notification date from the MAC (Medicare Administrative Contractors).
Once notification for revalidation is received, providers should
– Use the Internet-based PECOS (Medicare Provider Enrollment, Chain, and Ownership System) to review information currently on file and update and submit revalidation via the Internet,
– Submit an enrollment fee if specified in the notification and the revalidation is for an institutional provider (not an individual or group practice),
– Print, sign, date, and mail the certification statement along with all required supporting documentation to the appropriate MAC-failure to submit the enrollment forms as requested may result in the deactivation of the provider’s Medicare billing privileges.