US Medicare Provider and Supplier Enrollment (42 CFR Part 424 Subpart P)
Denial, revocation, deactivation, stay, rebuttals and appeals (424.530 to 424.547) – US Medicare Provider and Supplier Enrollment (42 CFR Part 424 Subpart P)

US Medicare Provider and Supplier Enrollment (42 CFR Part 424 Subpart P) 424.541: During a stay of enrollment (up to 60 days) remedy the noncompliance by the required change of information or revalidation submission; claims in the stay period are rejected unless compliance resumes before the stay ends, and a rebuttal may be filed within 15 days

CMS may stay an enrolled provider's or supplier's enrollment where it is noncompliant with at least one enrollment requirement (including where a change of information or revalidation application was rejected) and can remedy the noncompliance by submitting the applicable change of information or revalidation application; the stay runs from the date noncompliance began or the rejection date, for up to 60 days, and ends when CMS determines compliance has resumed or the period expires. During the stay the provider remains enrolled but claims with dates of service in the stay period are rejected, becoming payable on resubmission only if compliance resumes on or before the stay ends. CMS notifies the provider in writing; the provider may submit within 15 calendar days (extendable) a written, signed and dated rebuttal stating the facts and issues disputed, the reasons and all supporting documentation, signed by the individual supplier, an authorized or delegated official or a legal representative; a late or noncompliant rebuttal waives the right, the determination is not appealable, and CMS may still deactivate or revoke during the review.

Maintained by Gerard Blokdyk

Other controls in Denial, revocation, deactivation, stay, rebuttals and appeals (424.530 to 424.547) – US Medicare Provider and Supplier Enrollment (42 CFR Part 424 Subpart P)

Query this from an agent

The graph holds this control, the 0 it maps to, and the evidence behind each claim, over MCP and REST.