Do appeal rights exist for disaffirmed revalidations and reactivations?

Answer:
The NSC is tasked with ensuring entities requesting billing privileges and those already enrolled meet the standards set forth in 42 CFR 424.57.

The appeal rights established in 42 CFR 405.874 exist for suppliers whose request for billing privileges were denied or for existing suppliers whose privileges were revoked.

When a supplier revalidates (formerly re-enroll) or submits a reactivation, the supplier is neither requesting billing privileges nor appealing the decision to revoke those privileges. Therefore, no appeal rights exist for disallowed revalidations or reactivations.

Suppliers whose revalidations or reactivations could not be processed or were found not to meet the standards are required to begin the process again. This entails submitting a CMS 855S or the associated Provider Enrollment Chain and Ownership System (PECOS) enrollment information in its entirety along with all required attachments.

Contact NSC

Email National Supplier Clearinghouse

Contact a specific NSC department

Telephone: 866-238-9652

IVR: 866-238-9652

Address:

National Supplier Clearinghouse

Palmetto GBA, AG-495

P.O. Box 100142

Columbia, SC 29202-3142

Other Palmetto GBA Sites

Palmetto GBA Home

DMEPOS Competitive Bidding Program

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Jurisdiction M Home Health and Hospice MAC

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National Supplier Clearinghouse MAC

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