PMID- 18677828
OWN - HSR
STAT- MEDLINE
DCOM- 20080912
LR  - 20191210
IS  - 0097-6326 (Print)
IS  - 0097-6326 (Linking)
VI  - 73
IP  - 125
DP  - 2008 Jun 27
TI  - Medicare program; appeals of CMS or CMS contractor determinations when a provider 
      or supplier fails to meet the requirements for Medicare billing privileges. Final 
      rule.
PG  - 36448-63
AB  - This final rule implements a number of regulatory provisions that are applicable 
      to all providers and suppliers, including durable medical equipment, prosthetics, 
      orthotics, and supplies (DMEPOS) suppliers. This final rule establishes appeals 
      processes for all providers and suppliers whose enrollment, reenrollment or 
      revalidation application for Medicare billing privileges is denied and whose 
      Medicare billing privileges are revoked. It also establishes timeframes for 
      deciding enrollment appeals by an Administrative Law Judge (ALJ) within the 
      Department of Health and Human Services (DHHS) or the Departmental Appeals Board 
      (DAB), or Board, within the DHHS; and processing timeframes for CMS' Medicare 
      fee-for-service (FFS) contractors. In addition, this final rule allows Medicare 
      FFS contractors to revoke Medicare billing privileges when a provider or supplier 
      submits a claim or claims for services that could not have been furnished to a 
      beneficiary. This final rule also specifies that a Medicare contractor may 
      establish a Medicare enrollment bar for any provider or supplier whose billing 
      privileges have been revoked. Lastly, the final rule requires that all providers 
      and suppliers receive Medicare payments by electronic funds transfer (EFT) if the 
      provider or supplier, is submitting an initial enrollment application to 
      Medicare, changing their enrollment information, revalidating or re-enrolling in 
      the Medicare program.
CN  - Centers for Medicare and Medicaid Services, HHS
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Fed Regist
JT  - Federal register
JID - 7808722
MH  - Centers for Medicare and Medicaid Services, U.S.
MH  - Contract Services/*legislation & jurisprudence
MH  - Electronic Data Processing/*legislation & jurisprudence
MH  - Fee-for-Service Plans/*legislation & jurisprudence
MH  - Humans
MH  - Medicare Assignment/*legislation & jurisprudence
MH  - Time Factors
MH  - United States
EDAT- 2008/08/06 09:00
MHDA- 2008/09/16 09:00
CRDT- 2008/08/06 09:00
PHST- 2008/08/06 09:00 [pubmed]
PHST- 2008/09/16 09:00 [medline]
PHST- 2008/08/06 09:00 [entrez]
PST - ppublish
SO  - Fed Regist. 2008 Jun 27;73(125):36448-63.