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Code of Federal Regulations (Last Updated: May 6, 2024) |
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Title 42 - Public Health |
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Chapter IV—Centers for Medicare & Medicaid Services, Department of Health and Human Services |
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SubChapter B—Medicare Program |
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Part 424 - Conditions for Medicare Payment |
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Subpart P - Requirements for Establishing and Maintaining Medicare Billing Privileges |
§ 424.527 - Provisional period of enhanced oversight.
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§ 424.527 xxx
Link to an amendment published atCross Reference
Provisional period of enhanced oversight.
(a) New provider or supplier. Exclusively for purposes of both section 1866(j)(3) of the Act and this § 424.527, the term “new provider or supplier” is defined as any of the following:
(1) A newly enrolling Medicare provider or supplier. (This includes providers that are required to enroll as a new provider in accordance with the change in majority ownership provisions in § 424.550(b).)
(2) A certified provider or certified supplier undergoing a change of ownership consistent with the principles of 42 CFR 489.18. (This includes providers that qualify under § 424.550(b)(2) for an exception from the change in majority ownership requirements in § 424.550(b)(1) but which are undergoing a change of ownership under 42 CFR 489.18).
(3) A provider or supplier (including an HHA or hospice) undergoing a 100 percent change of ownership via a change of information request under § 424.516.
(b) Effective date. The effective date of a provisional period of enhanced oversight that is commenced under section 1866(j)(3) of the Act is the date on which the new provider or supplier submits its first claim.
[88 FR 77877, Nov. 13, 2023
.]