CMS Extends Revalidation Deadline

If Medicare hasn't asked you to revalidate your enrollment, you now have more time to do so. Efforts on physicians' behalf by TMA and the American Medical Association paid off when the Centers for Medicare & Medicaid Services (CMS) granted a request to delay the requirement that physicians revalidate their Medicare enrollment through 2015  [PDF].

Physicians do not have to act until they get a revalidation request from TrailBlazer Health Enterprises, CMS said. TrailBlazer began sending revalidation letters to physicians at the end of September. Those who have received a letter must go ahead and "respond to the request by completing the application either through internet-based PECOS [Provider Enrollment, Chain, and Ownership System] or by completing the appropriate 855 application form," CMS said.

CMS originally said the federal Affordable Care Act requires all physicians, other health care professionals, and suppliers to revalidate their enrollment by March 23, 2013, as part of its fraud, waste, and abuse prevention efforts. CMS said it reevaluated the law's revalidation requirement and "believes it affords the flexibility to extend the revalidation period for another two years. This will allow for a smoother process for providers and contractors. Revalidation notices will now be sent through March of 2015."

CMS posted a list of physicians already asked to revalidate their enrollment on it website. The list is updated monthly and has the name and National Provider Identifier of each provider who was mailed a revalidation letter and the date it was mailed. CMS says physicians who are listed but have not received the request should contact TrailBlazer.

CMS also announced it is making several changes to PECOS that should make revalidation less onerous for physicians. The changes include the capability for e-signatures, the ability to upload documents electronically, and fewer duplicative document-submission requirements.

TMA's Payment Advocacy staff says the delay will give CMS time to implement the enhancements, test the system, and work out any problems, and will give TrailBlazer and other Medicare contractors more time to complete the revalidation process.


Action, Nov. 15, 2011


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