Medicare and Medicaid Programs: Changes in Provider and Supplier Enrollment, Ordering and Referring, and Documentation Requirements; and Changes in Provider Agreements

Document ID: CMS-2010-0187-0029
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: 2012-09994
CFR Citation: 42 CFR Parts 424 and 431
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Details Information

Abstract: This final rule finalizes several provisions of the Affordable Care Act implemented in the May 5, 2010 interim final rule with comment period. It 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. In addition, it requires physicians and other professionals who are permitted to order and certify covered items and services for Medicare beneficiaries to be enrolled in Medicare. Finally, it mandates document retention and provision requirements on providers and supplier that order and certify items and services for Medicare beneficiaries.
Received Date: April 27 2012, at 12:00 AM Eastern Daylight Time
Start-End Page: 25284 - 25318
Page Count: 35
Comment Start Date: April 27 2012, at 12:00 AM Eastern Standard Time

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