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CMS Waives Provider Enrollment and Screening Requirements in California during Wildfire Recovery Efforts

CMS Waives Provider Enrollment and Screening Requirements in California during Wildfire Recovery Efforts 

The Centers for Medicare & Medicaid Services (CMS) is providing immediate relief to people who want to make a Medicare Part A or Part B enrollment request, but may have been impeded by the recent hurricanes and the wildfires in California. 

CMS Administrator Seema Verma announced that the Agency has established a hotline for certain healthcare providers and suppliers in the impacted areas in California to call in order to enroll in Medicare and receive temporary billing privileges.  

“This is an unprecedented opportunity to work with healthcare providers to put our patients and people with Medicare first,” said Administrator Verma. “While we have heard from providers and suppliers that are willing and able to help, we know that by temporarily relaxing certain Medicare provider and supplier enrollment requirements, we can make the services of skilled professionals more readily available to those in need. We are working to ensure that doctors, facilities, suppliers, and their teams are in place to help those impacted by damage from the California wildfires.” 

The new toll free Hotline Telephone Number: 1-855-259-2396
Hours of Operation: 8:00 AM – 6:00 PM PDT  

CMS established a toll-free hotline servicing Medicare’s Part B providers and suppliers in California. The hotline is intended for non-certified Part B suppliers, physicians and non-physician practitioners to receive temporary Medicare billing privileges under its waiver authority. Noridian Healthcare Solutions LLC, the Medicare Administrative Contractor (MAC) responsible for enrolling most Medicare Fee-For-Service providers and suppliers in California, will work to assist providers and suppliers in the state to temporarily enroll in Medicare. As part of this effort, CMS is waiving the following Medicare enrollment requirements for non-certified Part B suppliers, physicians and non-physician practitioners in the state of California: 

  1. Application fee (42 CFR § 424.514)
  2. Fingerprint-based criminal background checks (42 CFR § 424.518(c)(2)(ii) and (d))
  3. Site visits – (42 CFR § 424.510(d)(8) and §424.517)
  4. In-state licensure requirements (42 CFR § 424.510(d)(2)(iii)(A) and 424.516(a)(2)) 

Beginning Monday, October 30, 2017, certain providers and suppliers will be able to request temporary Medicare billing privileges over-the-phone and receive privileges the same day. In addition, CMS is: 

  • Exercising waiver authority to allow providers who are not currently enrolled to receive temporary Medicare billing privileges by providing limited information, including, but not limited to, National Provider Identifier (NPI), Social Security Number (SSN) or a business Employer Identification Number or Taxpayer Identification Number (SSN/EIN/TIN), and valid in-state or out-of-state licensure.
  • Temporarily ceasing revalidation efforts for Medicare providers and suppliers located in California areas otherwise directly impacted by the wildfires so providers and suppliers who would otherwise be required to revalidate their enrollment can focus on their patients.
  • Waiving the practice location reporting requirements and not taking administrative actions with respect to providers or suppliers who fail to notify CMS of their temporary practice location via the CMS-855 enrollment application. This temporary process will remain in effect from the declared disaster effective dates (October 8, 2017) until the disaster designation is lifted, after which time the provider shall resume all reporting requirements. If the temporary location is still being utilized until the previous location is re-established, it must be reported to the appropriate MAC through the appropriate CMS-855 enrollment application. 

CMS will continue to work with California in their recovery. The Agency continues to update its emergency page (www.cms.gov/emergency) with important information for state and local officials, providers, healthcare facilities, and the public. 

To read previous updates regarding HHS activities related to the California wildfires, please visit https://www.hhs.gov/about/news

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