Section 6401(a) of the Affordable Care Act requires all enrolled Medicare providers and suppliers to revalidate their enrollment information under new enrollment screening criteria. These new screening standards are designed to prevent fraud in the Medicare system.

Only the providers and suppliers who submitted their original Medicare enrollment applications before March 25, 2011 will be required to revalidate their enrollment information.

From now until March 2015, Medicare Administrative Contractors (MACs) will send out revalidation notices intermittently to initiate the revalidation process for each Medicare provider. Providers must submit the revalidation application by the date their MAC has established.

The revalidation forms can be completed via CMS’s website: https://pecos.cms.hhs.gov. Failure to submit the revalidation forms could result in a deactivation of Medicare billing privileges.

For 2012, providers will have to pay a revalidation filing fee of $523 if they are an institutional provider (i.e. all Medicare providers except physicians, non-physician practitioners, physician group practices, and non-physician practitioner group practices).

The Medicare revalidation effort does not change other aspects of the Medicare enrollment process. Providers should continue to submit routine changes as they always have.
For a sample of the revalidation letter that the MACs will be sending Medicare providers, visit: https://www.cms.gov/MedicareProviderSupEnroll/Downloads/SampleRevalidationLetter.pdf

If you or your organization needs assistance with completing the Medicare revalidation process, contact DLM Legal at info@dlmlegal.com or 216.635.0002.