As part of the overhaul of the enrollment rules in June 2006, CMS adopted new regulations under 42 C.F.R. § 424.510(d)(8) authorizing on-site reviews to determine if an enrolled provider or supplier is “operational” to furnish Medicare covered items or services and whether or not the provider or supplier is in compliance with the Medicare enrollment requirements. These site verifications are in addition to on-site surveys performed for determining compliance with the conditions of participation for Medicare-certified providers and suppliers.
Medicare for Geeks is written by Donna J. Senft, an attorney and shareholder in Baker Donelson's Health Law Group. Donna has nearly a decade of experience in advising enrolled providers to maintain complete PECOS data and complete revalidations to avoid deactivation or revocation of billing privileges, and to file CAPs and appeals when privileges are lost. She also helps providers with coding and payment issues, peer review and professional standards, and professional disciplinary matters.
Baker Donelson's Health Law Group dates back nearly 35 years, to the beginnings of health law as a recognized practice area. The Group is a leader in providing premier legal services to academic and community hospitals, health systems, long-term care facilities, clinical laboratories, institutional pharmacies, physicians and physician organizations.