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Announcing the Release of the Revised CMS-855 Medicare Enrollment Applications (GEN)
Posted April 9, 2008
MLN Matters Number: SE0810
Related Change Request (CR) #: N/A
It's Not Too Late to Give and Get the Flu Shot! In the U.S., the peak of flu season typically occurs anywhere from late December through March, however, flu season can last as late as May. Each office visit presents an opportunity for you to talk with your patients about the importance of getting an annual flu shot and a one time pneumococcal vaccination. Protect yourself, your patients, and your family and friends by getting and giving the flu shot. Don't Get the Flu. Don't Give the Flu. Get Vaccinated! Remember - Influenza and pneumococcal vaccinations and their administration are covered Part B benefits. Note that influenza and pneumococcal vaccines are NOT Part D covered drugs. You and your staff can learn more about Medicare's coverage of adult immunizations and related provider education resources, by reviewing Special Edition MLN Matters article SE0748 at www.cms.hhs.gov/MLNMattersArticles/downloads/SE0748.pdf on the Centers for Medicare & Medicaid Services (CMS) Web site.
Provider Types Affected
All Medicare physicians, providers, and suppliers.
Background
The Centers for Medicare & Medicaid Services (CMS) issued revised CMS-855 Medicare enrollment applications in March 2008. With the exception of providers enrolling as a specialty hospital on the CMS-855A, Medicare contractors will continue to accept the 2006 version of the Medicare enrollment application through June 2008. Providers and suppliers should begin to use the new Medicare enrollment applications immediately. Initially, these applications will be available only from the CMS provider enrollment Web site. The link for that CMS Web site is listed in the "Additional Information" section of this article.
Over the last year, CMS has received numerous comments and suggestions regarding the proposed revisions to the Medicare enrollment applications. CMS reviewed the comments and adopted many of the suggested revisions. Also, CMS incorporated a number of enhancements and changes (see "Key Points" below) to clarify the enrollment process and to reduce the burden imposed on the provider and supplier communities.
Key Points
This Special Edition article outlines the significant revisions to the Medicare enrollment applications and they are as follows:
Application-Specific Changes for Physicians and Non-Physician Practitioners (CMS-855I)
- Removed the requirement in Section 17 that providers attached their National Provider Identifier notification that is received from the National Plan and Provider Enumeration System.
Application-Specific Changes for Clinics/Group Practices and Certain Other Suppliers (CMS-855B)
- Removed the supplier type "Voluntary Health/Charitable Agency" from Section 2A.
- Clarified reporting timeframes throughout the CMS-855B.
- Added additional information about the National Provider Identifier (NPI) - legacy association and expanded the number of NPI - legacy combinations that a provider may enter in Section 4A from one to five.
- Removed the requirement in Section 17 that providers attach their National Provider Identifier notification that is received from the National Plan and Provider Enumeration System.
- Required that an Independent Diagnostic Testing Facility (IDTF) submit copies of its comprehensive liability insurance policy in Section 17.
- Added a list of the new IDTF standards found in 42 CFR 410.33(g) on a separate page in Attachment 2.
- Added instructions that explain the IDTF liability insurance requirements in 42 CFR 410.33(g)(6) to Attachment 2.
Application-Specific Changes for Institutional Providers (CMS-855A)
- Revised Section 2A2 to include a specific box that specialty hospitals must check when completing the application. Instructions explaining the definition of a "specialty hospital" were also added to the form.
- Clarified the term "primary practice location" in the instructions in Section 4. (The clarification did not change any data elements on the form.)
- Added additional information about the National Provider Identifier (NPI) - legacy association and expanded the number of NPI - legacy combinations that a provider may enter in Section 4A from one to five.
- Removed the data element "Medicare Year-End Cost Report Date" from Section 2.
- Removed the requirement in Section 17 that providers attach their National Provider Identifier notification that is received from the National Plan and Provider Enumeration System.
Application-Specific Changes for DMEPOS Suppliers (CMS-855S)
- Added supplier standards 22 - 25 to the list of DMEPOS supplier standards found on page 31.
Additional Information
For additional information regarding the Medicare enrollment process, including the mailing address and telephone number for the carrier or FI serving your area, visit www.cms.hhs.gov/MedicareProviderSupEnroll on the CMS Web site.
Special Edition article SE0612 contains helpful information about the Medicare enrollment process. You may review that article at www.cms.hhs.gov/MLNMattersArticles/downloads/SE0612.pdf on the CMS Web site.
Disclaimer
This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents. |
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