US Medicare Provider and Supplier Enrollment (42 CFR Part 424 Subpart P)
Sale or transfer of billing privileges, payment liability, overpayments, moratoria and rural emergency hospitals (424.550 to 424.575) – US Medicare Provider and Supplier Enrollment (42 CFR Part 424 Subpart P)

US Medicare Provider and Supplier Enrollment (42 CFR Part 424 Subpart P) 424.555,424.565: Do not bill or collect for services furnished while deactivated, denied, revoked or under a stay; refund beneficiaries promptly; bear the expense yourself; and expect an overpayment assessment for unreported practice location changes or adverse actions

What does 424.555,424.565 require?

No payment may be made for otherwise covered items or services furnished by a DMEPOS supplier without current billing privileges, or by any provider or supplier whose billing privileges are deactivated, denied or revoked or who is under a stay of enrollment (except where the stay ends with compliance restored as 424.541 allows); the beneficiary has no financial responsibility and the provider or supplier must refund on a timely basis any amounts collected from the beneficiary, bears the expense itself, and may be criminally liable for pursuing such payments under section 1128B(a)(3). A physician or nonphysician practitioner or organisation that fails to report an adverse legal action or a change of practice location within 30 days is assessed an overpayment back to the date of the action or change, processed under Part 405 subpart C.

Maintained by Gerard Blokdyk

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