The Centers for Medicare & Medicaid Services (CMS) recently issued a transmittal revising section 15.13 of Chapter 15 of the Program Integrity Manual for provider enrollment. The revised section mandates a denial of new enrollment applications or change of ownership applications when a physician, non-physician practitioner, or owner of a current provider or supplier owes an overpayment of $1500 or more. The revised section will go into effect on October 1, 2013 and will be implemented on October 7, 2013.
The transmittal regarding enrollment denials for an existing overpayment is available at: http://cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R469PI.pdf.
Centers for Medicare & Medicaid Services. “Enrollment Denials When an Existing or Delinquent Overpayment Exists.” Transmittal 469. 31 May 2013.