All providers and suppliers who enrolled in the Medicare program prior to 
Friday, March 25, 2011, will be required to revalidate their enrollment under 
new risk screening criteria required by the Affordable Care Act (section 
6401a).  (Providers/suppliers who enrolled on or after Friday, March 25, 2011 
have already been subject to this screening, and need not revalidate at this 
time.)



In the continued effort to reduce fraud, waste, and abuse, CMS implemented new 
screening criteria to the Medicare provider/supplier enrollment process 
beginning in March 2011.  Newly-enrolling and revalidating providers and 
suppliers are placed in one of three screening categories - limited, moderate, 
or high - each representing the level of risk to the Medicare program for the 
particular category of provider/supplier, and determining the degree of 
screening to be performed by the Medicare Administrative Contractor (MAC) 
processing the enrollment application.

Between now and March 2013, MACs will be sending notices to individual 
providers/suppliers; please begin the revalidation process as soon as you hear 
from your MAC.  Upon receipt of the revalidation request, providers and 
suppliers have 60 days from the date of the letter to submit complete 
enrollment forms.  Failure to submit the enrollment forms as requested may 
result in the deactivation of your Medicare billing privileges.  The easiest 
and quickest way to revalidate your enrollment information is by using 
Internet-based PECOS (Provider Enrollment, Chain, and Ownership System), at 
https://pecos.CMS.hhs.gov.

Section 6401a of the Affordable Care Act requires institutional providers and 
suppliers to pay an application fee when enrolling or revalidating 
("institutional provider" includes any provider or supplier that submits a 
paper Medicare enrollment application using the CMS-855A; CMS-855B, not 
including physician and non-physician practitioner organizations; CMS-855S; or 
associated Internet-based PECOS enrollment applications); these fees may be 
paid via www.Pay.gov<http://www.Pay.gov>.

In order to reduce the burden on the provider, CMS is working to develop 
innovative technologies and streamlined enrollment processes - including 
Internet-based PECOS<https://pecos.cms.hhs.gov/>.  Updates will continue to be 
shared with the provider community as these efforts progress.

For more information about provider revalidation, review the Medicare Learning 
Network's Special Edition Article 
#SE1126<http://www.cms.gov/MLNMattersArticles/downloads/SE1126.pdf>, titled 
"Further Details on the Revalidation of Provider Enrollment Information."







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