Providers Must Report Enrollment Information Changes By Dictated Deadlines

All providers must report enrollment information changes to their Medicare Administrative Contractor (MAC) within 30 days for a change in ownership, an adverse legal action, or a change in practice location, or 90 days for all other changes. Failure to do so could result in the revocation of your Medicare billing privileges.

This applies to all physicians, non-physician practitioners (i.e., physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, certified nurse midwives, clinical social workers, clinical psychologists, registered dietitians or nutrition professionals) and physician and non-physician practitioner organizations.

You can report changes to your MAC via the Internet-based Provider Enrollment, Chain and Ownership System (PECOS) or the CMS 855 paper enrollment application.

For more information on compliance with 42 Code of Federal Regulations (CFR) Section 424.516(d) go to:

  • Office of Inspector General report on MEDICARE: VULNERABILITIES RELATED TO PROVIDER ENROLLMENT AND OWNERSHIP DISCLOSURE
  • Centers for Medicare & Medicaid Services (CMS) report on Timely Reporting of Provider Enrollment Information Changes
  • CMS report on Details for title: Reporting Changes in Ownership
Liked the article? Share with friends: