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HHS/CMS RIN: 0938-AQ01 Publication ID: Fall 2010 
Title: ●Changes in Provider and Supplier Enrollment, Ordering and Referring, and Documentation Requirements; and Changes in Provider Agreements (CMS-6010-F) 
Abstract: This final rule implements several provisions set forth in the Affordable Care Act. Specifically, the rule requires providers and suppliers under title XVIII and XIX programs that qualify for a national provider identifier (NPI) to include their NPI on all applications to enroll in such programs and all claims for payment submitted under such programs. The rule also requires, in accordance with section 6405 of the Affordable Care Act, that physician and nonphysician practitioner (NPP) who are eligible to order and refer services for Medicare beneficiaries be enrolled in Medicare and adds requirements for physicians to provide documentation on referrals to programs at high risk of waste and abuse. 
Agency: Department of Health and Human Services(HHS)  Priority: Other Significant 
RIN Status: First time published in the Unified Agenda Agenda Stage of Rulemaking: Long-Term Actions 
Major: No  Unfunded Mandates: No 
CFR Citation: 42 CFR 424   
Legal Authority: 42 USC 1302 and 1395hh   
Legal Deadline:
Action Source Description Date
Final  Statutory    03/23/2010 
Timetable:
Action Date FR Cite
Interim Final Rule  05/05/2010  75 FR 24437   
Interim Final Rule Comment Period End  07/06/2010    
Final Action  05/00/2013    
Regulatory Flexibility Analysis Required: No  Government Levels Affected: None 
Federalism: No 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Agency Contact:
Jim Bossenmeyer
Health Insurance Specialist
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Mail Stop C3-02-16 , 7500 Security Blvd,,
Baltimore, MD 21244
Phone:410 786-9317
Email: james.bossenmeyer@cms.hhs.gov