Medicare Requiring Re-Validation of Providers


Between now and March 23, 2013, MACs will send out notices on a regular basis to providers that were enrolled in Medicare prior to March 25, 2011. Newly enrolled providers and suppliers that submitted their enrollment applications to CMS on or after March 25, 2011, are not required to re-validate. Providers and suppliers must wait to submit the re-validation until after being asked by their MAC to do so.

Section 6401 (a) of the Affordable Care Act established a requirement for all enrolled providers and suppliers to revalidate their enrollment information under new enrollment screening criteria. 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 Calendar Year (CY) 2011. 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.

For more information you can view the PDF from Medicare at