240.020 Deactivation of Medicare Billing Privileges–Appeal RightsHarsh Adverse Effects


Deactivation of Medicare Billing Privileges - Lack of Appeal Rights and Harsh Adverse Effects on Physicians: It is Texas Medical Association policy that (1) physicians who legitimately render services to Medicare patients be paid at their current practice's geographic index without disruption, allowing for backdating the reactivation of the privilege to bill for Medicare and Medicaid covered services to eligible patients; (2) physicians be provided due process and appeals process in order to be compensated for care actually provided to Medicare or Medicaid patients when their billing privileges are deactivated such as for failure to notify the Medicare or Medicaid carrier of change of office address using the proper Centers for Medicare & Medicaid Services (CMS) form; and (3) access issues for Medicare beneficiaries be considered before similar CMS regulations are created (Res. 414-A-10).

Last Updated On

October 07, 2016