New CMS Requirements: Medicare Enrollment Revalidation and Mandatory EFT Enrollment

July 9, 2012:

As part of new risk screening criteria required by the Affordable Care Act, all health care providers and suppliers who enrolled in Medicare before March 25, 2011, must have their enrollment revalidated. In addition, if you are not currently receiving Medicare payments through electronic funds transfer (EFT), you will have to agree to receive payments through EFT as part of the revalidation process.

If you submitted your enrollment application to Centers for Medicare and Medicaid Services (CMS) after March 25, 2011, you do not need to revalidate your enrollment.

• Wait until your MAC contacts you.

• Once you receive your revalidation notice, you will have 60 days from the date on the letter to submit complete enrollment forms.

• Once you submit your enrollment forms, you must print, sign, date and mail in your certification statement and all required supporting documentation immediately.

If you do not submit your forms by the deadline, CMS may deactivate your Medicare billing privileges.

Additional Tips

• The 2012 application fee for providers is $523; you can submit this fee on the PECOS website using a debit or credit card.

• Note that if you are not currently receiving payments through EFT, you will be required to submit the CMS-588 EFT form with the provider enrollment revalidation application.

• Providers who are in PECOS will have notices sent to their special payments and correspondence addresses at the same time. If these addresses are the same, the notice will be sent to your primary practice address.