Medicare and Medicaid Programs: Changes in Provider and Supplier Enrollment, Ordering and Referring, and Documentation Requirements, etc.

Document ID: CMS-2010-0187-0001
Document Type: Rule
Agency: Centers For Medicare & Medicaid Services
Topics: Emergency Medical Services, Health Facilities, Health Professions, Medicare, Reporting and Recordkeeping Requirements
Federal Register Number: 2010-10505
CFR Citation: 42 CFR Parts 424 and 431
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Details Information

Abstract:	This interim final rule with comment period implements several provisions set forth in the Patient Protection and Affordable Care Act (Affordable Care Act). It implements the provision which requires all providers of medical or other items or services and suppliers that qualify for a National Provider Identifier (NPI) to include their NPI on all applications to enroll in the Medicare and Medicaid programs and on all claims for payment submitted under the Medicare and Medicaid programs. This interim final rule with comment period also requires physicians and eligible professionals to order and refer covered items and services for Medicare beneficiaries to be enrolled in Medicare. In addition, it adds requirements for providers, physicians, and other suppliers participating in the Medicare program to provide documentation on referrals to programs at high risk of waste and abuse, to include durable medical equipment, prosthetics, orthotics and supplies (DMEPOS), home health services, and other items or services specified by the Secretary.
Document Subtype:	Interim Final w/ Comment Period
Received Date:	May 05 2010, at 09:43 AM Eastern Daylight Time
Start-End Page:	24437 - 24449
Page Count:	13
Comment Start Date:	May 5 2010, at 12:00 AM Eastern Standard Time
Comment Due Date:	July 6 2010, at 11:59 PM Eastern Standard Time