CMS Establishes $505 Provider/Supplier Application Fee for 2011
On March 23, 2011, the Centers for Medicare & Medicaid Services (CMS) published a notice announcing that the 2011 Medicare application fee for institutional providers (excluding physicians and nonphysician practitioners) is $505. Note that CMS has adopted a broad definition of institutional entities subject to the application fee; it applies to “any provider or supplier that submits a paper Medicare enrollment application using the CMS-855A, CMS-855B (not including physician and nonphysician practitioner organizations), CMS-855S or associated Internet-based PECOS enrollment application.” As authorized under CMS’s February 2, 2011 final Medicare/Medicaid/CHIP provider screening rule, institutional providers must pay the application fee when enrolling in Medicare, revalidating their Medicare enrollment, or adding a new Medicare practice location, effective March 25, 2011. Likewise, effective March 25, 2011 prospective or re-enrolling Medicaid or CHIP providers must submit the applicable application fee unless: (1) the provider is an individual physician or nonphysician practitioner; or (2) the provider is enrolled in Medicare or another state’s Medicaid or CHIP program and has already paid an application fee. The application fee will be used to fund new provider screening tools, such as unannounced site visits, background checks, and fingerprinting, and other program integrity efforts. The provider screening rule established a hardship exception process and allows Medicaid to waive the fees in certain circumstances. CMS also has released information on the mechanics of making application fee payments. For more information about the rule, see Reed Smith’s alert.
