CMS enrollment regulation elicits physician dread

New Medicare sign-up rules could swamp carriers and hurt access for patients.

By Markian Hawryluk, AMNews staff. July 14, 2003.

Washington -- A proposed expansion of Medicare's enrollment process runs counter to the Bush administration's efforts to reduce paperwork hassles in the program, according to physician groups.

In comments responding to a regulation proposed in April by the Centers for Medicare & Medicaid Services, the American Medical Association and other physician groups questioned the need for a variety of new enrollment rules they say will add to their regulatory burden but provide little or no value to the program.

"Precisely because the administration has made such great strides in its regulatory relief efforts to date, the AMA believes that it would be a serious mistake for CMS to impose the new and burdensome requirements contained in its proposed rule," AMA Executive Vice President Michael D. Maves, MD, said in a letter to the agency.

In an effort to minimize the program's exposure to fraud, the proposed rule would require all physicians to re-enroll, including an estimated 300,000 doctors who were not required to complete the Medicare enrollment form that went into effect in 1996.

The process would also be expanded to include on-site visits to verify enrollment data for some physicians, although few details about those visits were provided. And once enrolled, physicians would be required to revalidate their enrollment data every three years and meet tight deadlines for notifying Medicare about any changes or risk exclusion from the program.