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Medicare Participating Providers – Revalidation Applications

April, 2012

You may have already received a package from the local Medicare administrator for the Centers for Medicare & Medicaid Services ("CMS"). The package contains new enrollment forms for revalidation which you are required to complete and return within 60 days. If you did not receive this package yet, you will sometime in the next year or two.

This revalidation process is required under the Patient Protection and Affordable Care Act, and is intended to protect the Medicare program from sham providers. In the past, you were required to revalidate your application every 5 years. The new forms will make the revalidation process more involved and for most of you, will occur prior to your scheduled 5-year interval. Significantly, all providers will be required to disclose those persons with an ownership interest in and exercising control over your practice. This particular disclosure should not be a major burden for most physician practices but will be more of a burden for institutional providers. An application fee of $523.00 will be due with the 2012 revalidation application (the fee will change after that).

It is important that you accurately complete and return the forms within the stipulated 60 day period. Failure to do so could adversely affect your eligibility for Medicare reimbursement. If you have any questions concerning any of the above, including how to complete these forms, Davison & McCarthy can help.

Contact Mark D. Aurand for more information.