Ready for Medicare Provider Enrollment Revalidation 'Round Two?'

Get Your Questions Answered During Upcoming CMS Call

February 16, 2016 05:07 pm News Staff

Family physicians who count Medicare beneficiaries among their patients may want to reserve an hour or so in about two weeks to participate in a CMS call about the Medicare provider enrollment revalidation process.

[Male physician on phone, working on laptop]

First, some background.

Health care professionals who participate in Medicare must complete an enrollment application; once that application is validated, the clock starts ticking on a five-year revalidation cycle.

This revalidation period -- which effectively amounts to a physician's maintenance of Medicare billing privileges cycle -- was instituted by a provision( of the Patient Protection and Affordable Care Act of 2010 to prevent fraud within the Medicare system by ensuring that Medicare provider records are accurate.

Fast forward to 2016, and CMS is now reminding physicians that the next five-year period of Medicare provider revalidations has begun.

To help physicians understand the process -- and prepare for their next Medicare revalidation -- CMS is hosting a free provider call from 2 to 3:15 p.m. EST on March 1. Register today( because space may be limited.

CMS experts will discuss timing, improvements and updates for provider revalidation "round two" and will open the call for questions after those prepared remarks.

Physicians can brush up on the revalidation process to get ready for the call. Materials are available online(, as is a sample revalidation letter(

The provider call likely will reinforce important points such as these:

  • Medicare contractors will contact each physician directly when it is time to revalidate enrollment information.
  • Physicians should not act on revalidation until they are contacted.
  • Once physicians receive their revalidation request, they must submit supporting Medicare enrollment documentation within 60 days or risk losing Medicare billing privileges.

CMS will post the call presentation( at least one day in advance, and the agency plans to post an audio recording and transcript about two weeks after the event.

The target audience for the upcoming call is all Medicare fee-for-service providers and suppliers. However, physicians who have opted out of the Medicare program -- as well as those providers who are enrolled in Medicare for the sole purpose of ordering and referring items or services to Medicare beneficiaries -- are not required to participate in the revalidation program.

Lastly, CMS urges physicians to subscribe( to the weekly MLN Connects Provider eNews( for the latest Medicare program information, announcements of provider calls and other events, and education product updates.