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HHS/CMS | RIN: 0938-AP01 | Publication ID: Fall 2014 |
Title: Requirements for the Medicare Incentive Reward Program and Provider Enrollment (CMS-6045-F) | |
Abstract: This final rule implements various provider enrollment requirements. These include: expanding the instances in which a felony conviction can serve as a basis for denial or revocation of a provider or supplier's enrollment; if certain criteria are met, enabling us to deny enrollment if the enrolling provider, supplier, or owner thereof had an ownership relationship with a previously enrolled provider or supplier that had a Medicare debt; enabling us to revoke Medicare billing privileges if we determine that the provider or supplier has a pattern or practice of submitting claims that fail to meet Medicare requirements; and limiting the ability of ambulance suppliers to "backbill" for services performed prior to enrollment. | |
Agency: Department of Health and Human Services(HHS) | Priority: Economically Significant |
RIN Status: Previously published in the Unified Agenda | Agenda Stage of Rulemaking: Long-Term Actions |
Major: Yes | Unfunded Mandates: No |
CFR Citation: 42 CFR 405 42 CFR 424 42 CFR 498 | |
Legal Authority: 42 USC 1395ww |
Legal Deadline:
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Timetable:
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Additional Information: Includes Retrospective Review under E.O. 13563 | |
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: John Spiegel Director, Division of Policy and Regulatory Development, Medicare Program Integrity Group Department of Health and Human Services Centers for Medicare & Medicaid Services Center for Program Integrity, MS: AR-18-50, 7500 Security Boulevard, Baltimore, MD 21244 Phone:410 786-1909 Fax:410 786-0035 Email: john.spiegel@cms.hhs.gov |