A new Medicare enrollment fee is now in effect to cover the costs of the enhanced supplier screenings mandated in the Affordable Care Act (ACA). Effective March 25, 2011, all newly enrolling suppliers, revalidating suppliers, and/or suppliers opening a new location are required to pay a $505 fee upon submission of their Medicare (re)enrollment application (via the CMS-855S or PECOS). For suppliers opening or revalidating multiple locations, a separate $505 fee is required per location. The fee will be adjusted each year based on changes in the Consumer Price Index (CPI-U).

All currently enrolled suppliers are required to undergo re-validation (and pay an application fee) by March 23, 2012… even if your 3-year enrollment cycle is not scheduled to end until after this date. 

[Note: Many of you may have noticed that the NSC has basically stopped requesting re-enrollments due to a backlog of applications.  It now appears that the NSC will be forced to revalidate all suppliers within the next year.]

Coincidentally, the requirement for all suppliers to undergo revalidation no later than March 23, 2012 also falls during the same time that many suppliers will be simultaneously working towards renewing their accreditation. Accreditation was made mandatory in October of 2009, and suppliers must generally become reaccredited every 3 years.

Historically, suppliers have been instructed to wait until they receive a notice of re-enrollment letter from the NSC to being the revalidation process. At this time, the NSC has not released guidance on whether suppliers may voluntarily begin the reenrollment process prior to the March 23, 2012 deadline, or whether suppliers who are currently past due for revalidation may proactively start the process.

Full details on the new enrollment fee, including how the fee must be paid, are included in the April issue of  Vista Notes.

On August 17, 2009, CMS opened the registration window for competitive bidding. Providers who wish to place a bid will need to register with CMS’ Individuals Authorized Access Computer Services (IACS) system.  To register, please visit www.dmecompetitviebid.com, click on the Suppliers tab and then select Registration.

When registering, providers must appoint one authorized official (AO) and are encouraged to appoint one back-up authorized official (BAO) to manage their account. Both the AO and BAO must be listed as an AO on the provider’s CMS-855S enrollment form. AOs should register no later than September 14, 2009 and BAOs should register no later than October 9, 2009.

Any additional registrants beyond the provider’s AO and BAO are known as end users (EUs).  EUs have limited capabilities, such as filling out electronic bid forms, and may register until the close of the registration window on November 4, 2009 at 9:00pm EST. After this time, AOs may update company information, but no additional registrants will be accepted.

Prior to registration, it’s important that providers ensure their information is up-to-date and on file with the NSC and SSA. Information entered into IACS will be compared against information in the NSC (physical address, supplier number) and SSA (legal name, DOB, SSN) databases and must match exactly.

In most cases, the NSC is allotted up to 45-days to process all change of information (COI) requests. Per CMS, providers must wait 5 additional days after receiving confirmation from the NSC that their COI has been processed to update their information in the IACS system. However, the NSC has recently agreed to allow expedited faxed processing of sections 6 and 15 of the CMS-855S, when used to update AO information only. If you are only updating sections 6 and 15 of the 855S form, fax it to: 803.387.2407. For all other updates, the form must still be sent via standard postal mail.

For complete details on the registration process, bid forms, documentation requirements and bid rules, we invite you to attend Andrea Stark’s “Competitive Bidding: What to Expect this Time Around” webinar on August 27, 2009 at 2:00pm EST. You may register for the event or purchase a digital recording via the Seminars/Webinars page of this website.

By: Michelle Duncan

Effective June 1, 2009 DMEPOS suppliers submitting applications to Medicare must use the revised CMS-855S form. Applications submitted after June first using the old 855-S form will be rejected.

The revised CMS-855S adds a 26^th Supplier Standard – “All DMEPOS suppliers must obtain a surety bond in order to receive and retain a supplier billing number” – and includes a new section for reporting surety bond information (Section 12).

Unless a supplier believes they are exempt (see: Surety Bond Final Rule: Multiple NPIs may Cost You Big Bucks article below), the following information must be reported in Section 12 of the revised form: 

• Surety Bond Company (the company who will be held liable for your bond)
  • The company’s Name and address (as reported to the IRS)
  • The company’s E-mail address, fax and phone number
  • The company’s Tax identification number (TIN)
• Insurance Agency / Broker (the agency/broker who issued your bond)
  • The agency / broker’s name and address (as reported to the IRS)
  • The agency / broker’s TIN
  • The name of the individual agent who issued your bond
• The Surety Bond amount, number, and effective date
• A copy of your surety bond must be submitted with the application. 

CMS encourages suppliers to begin using the revised CMS-855S immediately. Per the form’s instructions, you should submit a CMS-855S to Medicare if you are: 

• Enrolling in Medicare for the first time as a DMEPOS supplier.
• Currently enrolled in Medicare as a DMEPOS supplier and need to report changes to your business, other than enrolling a new business location (e.g., you are adding, deleting, or changing existing information under this Medicare supplier billing number). Changes must be reported within 30 days of the effective date of the change.
• Currently enrolled in Medicare as a DMEPOS supplier but need to enroll a new business location. This is to add a new location to an organization with a tax identification number already listed with the NSC. (This differs from changing information on an already existing location.)
• Currently enrolled in Medicare as a DMEPOS supplier and have been asked to verify or update your information. This includes situations where you have been asked to attest that your organization is still eligible to receive Medicare payments.
• Reactivating your Medicare DMEPOS supplier billing number (e.g., your Medicare supplier billing number was deactivated because of non-billing, and you wish to receive payment from Medicare for future claims).
• Voluntarily terminating your Medicare DMEPOS supplier billing number.

A full NSC Application Package, which includes the updated CMS-855S, is available via our products page. The package also includes: tips for filling out the new form, detailed instructions on how to document your existing TIN and NPI, comprehensive required documentation checklists, and more!

A copy of the CMS-855S is also available here.