Application Fees

To help offset the costs of the screening required under the program safeguard rules for Medicare-enrolled providers and suppliers, an application fee was implemented.   With the annual update factor, the current fee for $505.00 for 2011 and $523.00 for 2012.

Application fees are assessed at the time of the initial Medicare enrollment, when a practice location is added, and when responding to a revalidation request.  With the exception of individuals (physicians and non-physicians practitioners) and group practices, all other providers and suppliers are assessed the application fee.

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New Medicare and Medicaid Enrollment Rules Take Effect Today

Significant changes effecting Medicare- and Medicaid-enrolled providers and suppliers take effect today, March 25, 2011.  The new regulations are in response to provisions in the recent health care reform legislation designed to enhance the enrollment procedures to protect against fraud.  All Medicare-enrolled providers and suppliers were grouped into one of three categories “limited,” “moderate,” or “high” risk, with delineated enrollment screening procedures for each category.  The greater the perceived risk of fraud, the more scrutiny for the applicant or enrollee.

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60-Day Comment Period for New Medicare and Medicaid Enrollment Rules Ends November 16, 2010

Do not lose this opportunity to submit comments to the proposed changes in the Medicare and Medicaid enrollment rules, whether submitted individually or in conjunction with professional or trade associations.

Enrollment screening procedures would be increasing more rigorous based upon the provider’s or supplier’s placement into the “limited,” “moderate,” or “high” risk category.

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