Docs to revalidate Medicare enrollment with CMS anti-fraud efforts

If you enrolled to participate in Medicare anytime prior to March 25, 2011, be on the lookout for a letter from your Medicare Administrative Contractor (MAC) requesting you revalidate your enrollment. As part of new screening criteria from the Centers for Medicare & Medicaid Services (CMS) to reduce waste, fraud, and abuse, this administrative chore is not optional.

According to CMS, providers and suppliers have 60 days from the date of the letter (which could arrive anytime before March 2013) to submit complete enrollment forms. Failure to submit the requested enrollment forms may result in the deactivation of your Medicare billing privileges, CMS stated in the notice.

For some doctors, the revalidation process will be similarly tedious and confusing as when they first signed up with Medicare, American Medical News reports. And given the scope of this revalidation effort that affects roughly 750,000 physicians, officials fear serious backlogs.

"We have very significant concerns with this revalidation effort in light of the problems physicians have had with enrollment and revalidation efforts in the past," said American Medical Association President Dr. Peter W. Carmel. "The AMA is making this a priority and urging CMS to reconsider this action."

According to Allison Brown, a senior advocacy adviser with the Medical Group Management Association, CMS has planned efficiency-enhancing improvements to the enrollment website that could be implemented by January 2012. In the meantime, the easiest and quickest way to revalidate your enrollment information is by using the Internet-based Provider Enrollment, Chain, and Ownership System (PECOS), wrote practice management blogger Mary Pat Whaley. CMS is working to streamline this system too and will continue to share how efforts progress with the provider community, she added.

To learn more:
- read the article from American Medical News
- see the post from Manage My Practice
- check out the PECOS website

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