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HHS/CMS RIN: 0938-AH73 Publication ID: Fall 2000 
Title: Requirements for Establishing and Maintaining Medicare Billing Privileges (HCFA-6002-P) 
Abstract: This rule would establish a requirement that all providers and suppliers (other than physicians who have entered into a private contract with a beneficiary) must complete an enrollment form, submit specified information to us, and periodically update and certify the accuracy of the enrollment information in order to receive and maintain billing privileges in the Medicare program. The information must clearly identify the provider or supplier and its place of business, provide documentation that it is qualified to perform the services for which it is billing, and assure that it is not currently excluded from the Medicare program. If we determine the information submitted is incomplete, invalid, or insufficient to meet Medicare requirements, we would reject, deny, inactivate, or revoke billing privileges. 
Agency: Department of Health and Human Services(HHS)  Priority: Other Significant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Proposed Rule Stage 
Major: No  Unfunded Mandates: No 
CFR Citation: 42 CFR 424   
Legal Authority: 42 USC 1302    42 USC 1395hh   
Legal Deadline:  None
Timetable:
Action Date FR Cite
NPRM  12/00/2000    
Additional Information: Formerly known as HCFA-1023-P
Regulatory Flexibility Analysis Required: No  Government Levels Affected: None 
Federalism: No 
Included in the Regulatory Plan: No 
Agency Contact:
Michael Collett
Health Insurance Specialist
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Office of Financial Management, Program Integrity Group, Division of Provider/Supplier Enrollment, N3-22-17, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-6121