Medicare's latest demand: You must sign up every 3 years

The plan from the Bush administration is a response to criticism that CMS doesn't screen out practitioners who defraud Medicare.

By Markian Hawryluk, AMNews staff. May 19, 2003.

Washington -- The Medicare enrollment process for physicians could begin to be like the ghoul in a low-grade horror movie. Just when you think you're done with it, it comes back to haunt you.

Despite efforts to streamline the process by which doctors apply for a Medicare billing number, the latest regulation proposed by the Bush administration includes what physicians view as a number of new hassles. It would require physicians to revalidate enrollment data every three years, institute onsite visits by investigators to verify applications, and force most physicians already treating Medicare patients to reapply to the program.

The rule proposed in April by the Centers for Medicare & Medicaid Services builds upon a simplified application form released in November 2002, but the new requirements have many physicians concerned.

Under the proposed process, doctors who were already billing the program before the initial enrollment form was introduced in 1996 will now have to complete a form so that the program has their data on file. Then every three years, physicians will receive a copy of the completed form. If none of the information has changed, physicians can simply sign the document and return it. Changes would require physicians to submit evidence to document the validity of the new information.

"We understand that the resubmission and update of enrollment information will place an obligation on providers and suppliers," CMS stated in the regulation. "We are considering a variety of ways to minimize the burden of this important information collection and verification provision, including use of Internet technology."