Keep Medicare Enrollment Information Correct and Current or Suffer Consequences

While most providers understand the need to bill Medicare correctly, many often fail to recognize the potentially disastrous results of not keeping Medicare informed of your correct and up-to-date practice information. A recent case highlights the dangers of a seemingly innocent error, which resulted in a physician’s Medicare billing privileges being revoked.

In a cautionary tale, a federal court in Hawaii recently upheld CMS revoking a physician’s Medicare billing privileges due to his failure to list a correct practice address on his Medicare enrollment and revalidation applications. The physician, an anesthesiologist who had been enrolled in Medicare for over 25 years, listed a UPS store address on his enrollment application in 2010 and re-confirmed that address as part of his revalidation in 2014. The physician contended that he correctly provided his mailing address since he did not have an office where he rendered services. CMS argued that he should have reported the location where he provided services. The court upheld CMS’s decision to revoke the physician’s Medicare billing privileges for two years.

Source: https://www.jdsupra.com/legalnews/keep-medicare-enrollment-information-97271/