Corporate Compliance

CMS issues transmittal on Medicare provider/supplier enrollment

Compliance Monitor, November 22, 2006

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CMS updated chapter 10 of is Medicare Program Intregity Manual with changes that went into effect November 15.

CMS noted the following most significant changes:

  • A provider must submit a complete CMS-855 application if it is submitting any change request via the CMS-855 and is not in the Provider Enrollment, Chain and Ownership System (PECOS).
  • Contractors must establish a complete enrollment record in PECOS prior to the approval or denial of a CMS-855 application.
  • Several other justifications for returning CMS-855 applications have been added to section 3.2 of chapter 10.
  • A new section has been added to chapter 10 that describes in detail the various types of business organizations that contractors may encounter.

    Click here to read the transmittal discussing the changes.



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