CMS will begin enforcing new restrictive provider enrollment policies beginning April 1. Under the new policies, physicians, non-physician practitioners, and physician or non-physician practitioner organizations may bill for services provided no more than 30 days prior to the effective date of enrollment. The effective date of enrollment will be the later of either the application date or the date the provider started seeing patients at the practice location. Providers should take steps to ensure timely submission of enrollment applications in order to avoid claim denials.
In addition, under the new rules, providers must report major changes such as changes in ownership or practice location and final adverse actions within 30 days.
A link to the CMS transmittal detailing the new rules as well as illustrative examples of how the new regulations will affect providers can be found here.