Medicare Revalidation Announcement
Centers for Medicare and Medicaid Services (CMS) just announced that they are moving forward with the revalidation requirements established in Section 6401 (a) of the Affordable Care Act. After completing their initial round of revalidations, CMS is now resuming regular revalidation cycles in accordance with 42 CFR §424.515. A brief review of the data indicates that only 2,804 chiropractic physicians in Illinois are enrolled in Medicare.
What this means to you:
- All chiropractic physicians will have to revalidate, either by the deadlines listed or by deadlines to be determined (TBD).
- Do not ignore this requirement. The ICS has received calls from doctors who failed to revalidate on time and lost their enrollment status and thus reimbursement with Medicare.
- Inform your staff to watch for a revalidation notice from CMS (either email or postal). The email notice will contain the subject line, “URGENT: Medicare Provider Enrollment Revalidation Request.”
- Periodically check the database to determine if you have been assigned a due date.
- Do NOT revalidate early. Medicare has clearly indicated, “All unsolicited revalidation applications submitted more than 6 months in advance of the provider/supplier’s due date will be returned.”
- Once your due date is posted, please revalidate no later than the date indicated. You can use PECOS to revalidate: https://pecos.cms.hhs.gov/pecos/login.do#headingLv1
Remember, chiropractic physicians, are NOT able to opt-out of Medicare. Therefore, if you treat patients who are of Medicare age, you must be enrolled (and eventually revalidate) in Medicare. If you would like a full understanding of why chiropractic physicians are unable to opt-out of Medicare, please review this article.
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Here are important resources you will need:
- MLN Matters Release: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1605.pdf.
- CMS website page dedicated to revalidation: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/Revalidations.html
- Link to check your revalidation status and due date: https://data.cms.gov/revalidation. Simply, enter your name or NPI in the available fields and click the Search button.
