Simione™ Healthcare Consultants

Be Alert for CMS Enrollment Revalidation Reports

The Centers for Medicare & Medicaid Services (CMS) Division of Enrollment Operations is beginning Cycle 2 of the provider and supplier revalidation process, as required under Section 6401 (a) of the Affordable Care Act. 
The Medicare Administrative Contractor (MAC) will send a revalidation notice within 2-3 months prior to the revalidation due date, either by email or regular mail.  Emails will be sent to email addresses reported on previous applications and will include "URGENT Medicare Provider Enrollment Revalidation Request" in the subject line.  Notices sent by mail will be sent to at least two of the reported addresses: correspondence, special payments, and/or the primary practice address.
Providers and suppliers should respond promptly to requests from their MAC.  If billing privileges are deactivated as a result of the provider or supplier's failure to respond to such request, reactivation will only be retroactive to the date of submission of a subsequently approved new enrollment application (not to the deactivation date), which will result in a gap in payment.  If deactivation occurs, the provider or supplier will maintain their original PTAN.
All providers should periodically review Medicare enrollment information on file.  Generally, changes are required to be made within ninety (90) days of the change.  Failure to maintain accurate information on file can have significant consequences.
Access the Medicare Revalidation Lookup Tool to check on your due date every couple of weeks, using your LEGAL business name. You will get a letter as well if you are at the address reported on your last submitted 855A. 
For more information, contact Nancy Boyd, Senior Manager, Simione Healthcare Consultants, at [email protected]

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