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HHS/CMS RIN: 0938-AH73 Publication ID: Fall 2005 
Title: Requirements for Establishing and Maintaining Medicare Billing Privileges (CMS-6002-F) 
Abstract: This final rule requires that all providers and suppliers (other than physicians who have elected to "opt-out" of the Medicare program) complete an enrollment form and submit specific information to CMS. This rule will requires that all providers and suppliers periodically update and certify the accuracy of their enrollment information to receive and maintain billing privileges in the Medicare program. In addition, this final rule will implement provisions in the Medicare statute that require CMS to ensure that all Medicare providers and suppliers are qualified to provide the appropriate health care services. These statutory provisions include requirements meant to protect beneficiaries and the Medicare Trust Funds by preventing unqualified, fraudulent, or excluded providers and suppliers from providing items or services to Medicare beneficiaries or billing the Medicare program or its beneficiaries. 
Agency: Department of Health and Human Services(HHS)  Priority: Other Significant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Final Rule Stage 
Major: No  Unfunded Mandates: No 
CFR Citation: 42 CFR 424   
Legal Authority: 42 USC 1302    42 USC 1395hh   
Legal Deadline:
Action Source Description Date
Final  Statutory  MMA 902  04/25/2006 
Timetable:
Action Date FR Cite
NPRM  04/25/2003  68 FR 22064   
Final Action  04/00/2006    
Regulatory Flexibility Analysis Required: No  Government Levels Affected: None 
Small Entities Affected: Businesses  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