American Speech-Language-Hearing Association
June 21, 2013

Medicare Revalidation for Provider Enrollment Continues

As provisions of the Patient Protection and Affordable Care Act continue to be implemented, audiologists and speech-language pathologists need to ensure they are responsive to Medicare administrative contractor (MAC) notices for revalidation.

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.

Once notification for revalidation is received, providers should

  • use the Internet-based PECOS 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.

Background

The Patient Protection and Affordable Care Act established a requirement for all enrolled providers and suppliers to revalidate their enrollment information under the new enrollment screening criteria. This revalidation effort applies to those providers and suppliers who were enrolled prior to March 25, 2011. Newly enrolled providers and suppliers who submitted their enrollment applications to the Centers for Medicare and Medicaid Services (CMS) on or after March 25, 2011, are not impacted. Between now and March 23, 2015, MACs will send out notices on a regular basis to begin the revalidation process for all providers and suppliers.

Visit the CMS website for a current list of all providers and suppliers who have been mailed a revalidation notice. If you are listed and have not received the request, please contact your MAC.

ASHA Resources

For more information, please contact ASHA's health care economics and advocacy team at reimbursement@asha.org.


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