Revalidating medicare enrollment

In addition, Medicare providers and suppliers should review the CMS website for a list of providers/suppliers listed by national provider number to see if a revalidation request has been sent (they are sometimes misplaced by the mail courier or misrouted within a provider organization).

Revalidation requirements are nothing new; law in existence prior to the passage of PPACA required all providers and suppliers to revalidate every five years (three years for durable medical equipment, prosthetics, orthotics and supplies (“DMEPOS”) suppliers), However, providers and suppliers irregularly received requests to revalidate their enrollment files.

This time around, revalidation will require that providers and suppliers be screened under the program integrity rules that went into effect under PPACA.

In addition, Medicare enrollees who are revalidating will need to provide content for new enrollment forms that were issued in 2011.

MMAC anticipates having an electronic portal for revalidations available in late 2015 or early 2016 Effective July 1, 2015, MMAC will begin revalidating all currently enrolled MO Health Net providers.

During the next two state fiscal years, MMAC will be concentrating on revalidating the approximately 20,000 currently enrolled physicians (MD and DO).

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