Enrollment regulations allow Medicare contractors to deny an enrollment application for a supplier, physician, or non-physician practitioner if there is an outstanding overpayment that has not been fully repaid at the time of filing the new application. The denial is triggered by an owner (for a group or supplier application) or provider (for an individual application) having an outstanding debt to the Medicare program. An “owner” is defined as anyone or entity with a 5% or greater ownership of the provider or supplier.
When an enrollment application is filed, Medicare contractors will determine if an owner or provider has an outstanding overpayment due the federal government. If a current due or delinquent overpayment is found, the application will be denied regardless of:
- Whether the person or entity is on a Medicare-approved plan of repayment or payments are currently being offset:
- Whether the overpayment is currently being appealed;
- The reason for the overpayment
See the Medicare Learning Network article MM8039 for complete details.
Call nCred today at 423.443.4525 opt#2 for assistance with your Medicare enrollment. Our experienced staff members can help remove the paperwork hassle of Medicare enrollment as well as commercial insurance network enrollment. Request information on our services and pricing.
