The Centers for Medicare & Medicaid Services (CMS) has issued Change Request 10443 that updates Medicare Program Integrity Manual related to policies for Medicare provider deactivations. The changes align the reasons for deactivation more accurately with the regulations at §242.540 and include several small changes in chapter 15 of the manual under sections 15.27and15.29.
Specifically, the contractor may deactivate a providers billing privileges for any reason without CMS’ review and approval, expect in cases when deactivating a HHA’s billing privileges unless the deactivation is due to failure to comply with a revalidation request.
Additionally, the time frame for when the contractors must send providers their revalidation notice letter has been increased from 75-90 days prior to the revalidation date to 90-105 days.
The regulation at §242.540(b)(3)(i) require a HHA, whose Medicare billing privileges have been deactivated, to obtain an State or accreditation survey before its Medicare billing privileges can be reactivated. However, CMS has confirmed for the National Association for Home Care & Hospice that this does not apply to deactivation related to revalidation since the provider agreement and the Provider Transaction Access Number (PTAN) remain intact.
Home heath and hospice providers are reminded to review the CMS web based revalidation list to ensure revalidations are completed timely. The list contains all Medicare enrolled providers and records the date for revalidation up to 6 months prior to a provider’s revalidation due date.
Rural Add-on Tables
CMS is rescinding Transmittal 2047, dated March 20, 2018, and replaced it with Transmittal 2051, dated, April 4, 2018 to include page 2 of Attachment B Rural Add on Rate Tables. All other information remains the same. The transmittal provides instructions to the Medicare Administrative Contractors on reprocessing claims related to several provisions of the Bipartisan Budget Act of 2018, (see NAHC Report Article).
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