Recent Medicare Enrollment & Billing Developments

CMS: Hospital Medicare Enrollment Reconfirmation Begins July 4
 
Medicare contractors will be requesting enrollment reconfirmation as of July 4, 2010 for those hospitals that receive Medicare reimbursements but are not part of Medicare's electronic enrollment system or do not have an Electronic Funds Transfer Agreement in place.  Enrollment confirmation will also be requested from hospitals with Medicare enrollment information that is over six (6) years old.
 
If your hospital receives such a request, you have 60 days to comply by submitting a Medicare Enrollment Application - Institutional Providers (CMS-855A).  The application may be submitted in one of the following ways: via mail, or via the internet using the Provider Enrollment, Chain, and Ownership System.
 
While billing numbers will not be revoked, failure to comply with the 60-day deadline will result in a report to CMS so that additional action may be taken.  Hospitals are urged to comply within the 60-day timeframe since the Conditions for Medicare Payment stipulate that hospitals revalidate enrollment information every five (5) years.

Submission Period for Medicare Claims Reduced

Previously, providers were required to submit written payment requests, or claims, within three (3) calendar years following the year in which provision of services occurred in order to receive reimbursement.  The Secretary of Health and Human Services ("HHS") had the authority to decrease the three-year period if required for the sake of efficiency.
 
In order to reduce fraud, waste, and abuse, the submission period for claims has been reduced pursuant to the Patient Protection and Affordable Care Act.  Accordingly, with respect to the provision of services under Medicare Parts A and B, the filing deadline for a written payment request has been decreased to one (1) calendar year from the date the services were rendered.  The effective date is March 23, 2010 and applies to all services provided on or after January 1, 2010.  The Secretary of HHS is authorized to determine exceptions to this new one (1) year period.
 
Payment requests must be filed prior to December 31, 2010 for services provided before January 1, 2010.   

If you would like additional information on recent Medicare enrollment and billing developments, please contact Regan E. Tankersley at (317) 977-1445 or rtankersley@hallrender.com or Brian D. Jent at (317) 977-1402 or bjent@hallrender.com.