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Final Medicare Rule Standardizes Physician Enrollment

By News Staff
4/28/2006

CMS has issued a final rule designed to standardize existing Medicare enrollment requirements and increase the efficiency with which physicians and other health care providers bill Medicare.

New and participating Medicare providers must complete the CMS-855 Medicare enrollment application. Currently enrolled physicians will be notified by CMS when they need to recertify their enrollment information, according to a CMS news release announcing the final rule, published in the April 21 Federal Register.

The regulation requires physicians and others participating in Medicare to
  • complete and submit a Medicare enrollment application to participate in Medicare,
  • report changes in enrollment data within 90 days of the change, and
  • recertify the accuracy of their enrollment information every five years.
In addition, "CMS anticipates issuing revisions to the existing CMS-855 Medicare enrollment applications in the near future," the release said. "The revised enrollment applications simplify the enrollment process and make it easier for providers and suppliers to complete and submit an enrollment application to Medicare."