The April 1, 2011 post on this blog presented a preview of things to come from
Medicare. That post addressed the prospect of unannounced on site visits
from Medicare. Final rules regarding eligible enrollment of PT have been
established by CMS.
Physical therapists that were enrolled in the Medicare prior to March 25, 2011
must revalidate their enrollment as required by the Affordable Care Act (ACA,
commonly referred to as Obamacare). Part of the reason for this new enrollment
is the classification of the new risk (fraud) screening criteria. As was
addressed in the aforementioned April 1, 20111 blog post, PT has been assigned
to the Moderate risk category for fraud. The risk categories (low, moderate,
high) determine the degree of screening that will be performed by MACs (Medicare
Administrative Contractors). As stated in the April posting, the moderate
risk classification means that PTs are subject to unannounced on site
inspections from Medicare Administrative Contractors.
Starting from today through March 2013, MACs will be notifying practitioners of
the need to re-enroll in Medicare. CMS has advised providers to begin
the revalidation process as soon as they hear from their MACs.
You only 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.
Tom Kane, PT