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