Notice Regarding Revalidation and Application Fee

Section 6401(a) of the Affordable Care Act also requires the Secretary to impose a fee on each “institutional provider of medical or other items or services and suppliers.”

In Change Request 7350, CMS discussed the final rule with comment period, titled, “Medicare, Medicaid, and Children’s Health Insurance Programs; Additional Screen Requirements, Application Screening Requirements, Application Fees, Temporary Enrollment Moratoria, Payment Suspensions and Compliance Plans for Providers and Suppliers” (CME-6028-FC). This rule was published in the February 2, 2011, edition of the “Federal Register.”

Background
Section 6401 (a) of the Affordable Care Act established a requirement for all enrolled providers and suppliers to revalidate their enrollment under new screening criteria. All DMEPOS suppliers enrolled with Medicare prior to March 25, 2011, must revalidate their enrollment information, but only after receiving a revalidation request from the National Supplier Clearinghouse (NSC). The Medicare provider enrollment effort does not change other aspects of the enrollment process. DMEPOS suppliers should continue to submit routine changes of information such as address, ownership and changes in products and services. The NSC will send revalidation notices on a recurrent basis to DMEPOS suppliers. Revalidation notices are mailed to the correspondence address on file for the supplier.

Section 6401(a) of the Affordable Care Act also requires the Secretary to impose a fee on each “institutional provider of medical or other items or services and suppliers.” The application fee is $505 for CY 2011. For CY 2012, the fee is $523 and for CY 2013, the fee is $532.00. CMS has defined “institutional provider” to mean any provider or supplier that submits a paper Medicare enrollment application using the CMS-855A, CMS-855B (except physician and non-physician practitioner organizations), or CMS-855S forms or associated Internet-based PECOS enrollment application.

All Institutional providers (including DMEPOS suppliers) who respond to a revalidation request must submit an enrollment fee by ACH debit, or credit card. Revalidations are processed only when fees have cleared. A confirmation screen will display when the payment has been successfully made. 

When you receive notification from the NSC to revalidate:

• Update your enrollment using
  • Internet-based PECOS
  • CMS- 855S Enrollment Application
• Pay your enrollment fee by going to the PECOS website