CMS announced guidance on inter-jurisdictional reassignments affecting providers in one MAC jurisdiction that re-assigns benefits to an organization located in another MAC jurisdiction. The full program guidelines can be found here.
Here is the text of the article:
“The following principles apply if a physician/NPP (reassignor) is reassigning his or her benefits to an entity (reassignee) located in another contractor jurisdiction – a practice that is permissible:
- The reassignor must be properly licensed or otherwise authorized to perform services in the state in which he or she has his or her practice location. The practice location can be an office or even the individual’s home.
- The reassignor need not – pursuant to the reassignment – enroll in the reassignee’s MAC jurisdiction nor be licensed/authorized to practice in the reassignee’s state. However, if the reassignor will be performing services within the reassignee’s state, the reassignor must enroll with the MAC for – and be licensed/authorized to practice in – that state.
- The reassignee must enroll in the MAC jurisdictions in which:
a. It has its own practice location(s); and
b. The reassignor has his or her practice location(s).
4. In Case 3b above, the reassignee should:
a. Identify the reassignor’s practice location as its practice location on its Form CMS-855B;
b. Select the practice location type as “Other health care facility” and specify “Telemedicine location” in Section 4A of its Form CMS-855B; and
c. Need not be licensed/authorized to perform services in the reassignor’s state.
For example: Suppose Dr. Smith is located in MAC Jurisdiction X and is reassigning his benefits to Jones Medical Group in MAC Jurisdiction Y. Jones must enroll with X and Y, but need not be licensed/authorized to perform services in Dr. Smith’s state. However, in Section 4 of the Form CMS-855B it submits to X, Jones must list Dr. Smith’s location as its practice location.”