Physicians Beware: CMS May Deny or Revoke Medicare Provider Privileges

April 16, 2015Articles Physicians News Digest

On February 3, 2015, the authority of the Centers for Medicare & Medicaid Services (CMS) to deny Medicare enrollment and revoke Medicare billing privileges of providers and suppliers significantly expanded. All physicians, and especially solo practitioners and physicians in group practices, should be aware that they could now be held responsible by CMS for overpayments or other outstanding debts of their prior practices or other Medicare billing entities to CMS. Providers should also know that CMS may deny enrollment or revoke a provider or supplier’s Medicare billing privileges if the provider or supplier, or an owner or a managing employee of the provider or supplier, has been convicted within the last 10 years of any state or federal felony which CMS determines is detrimental to the best interests of the Medicare program and its beneficiaries.

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