42 C.F.R. §424.540 - Deactivation of Medicare billing privileges
| Cite as | 42 C.F.R. §424.540 |
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4 cases
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Consumers' Checkbook Center v. U.S. Dept. Health, 07-5343.
...value of disclosure). One can infer without the requested data that an enrolled physician is performing at least some procedures. See 42 C.F.R. § 424.540(a)(1) (CMS may deactivate physician's Medicare billing privileges if no claims submitted for 12 consecutive months). Currently available ......
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Goffney v. Becerra, 19-56368
...that his Medicare billing privileges had been deactivated in 2008 because he had not submitted a claim for more than a year. See 42 C.F.R. § 424.540(a)(1). Goffney argues that the deactivation was erroneous, but although the regulations provide a mechanism for a provider to challenge a deac......
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Med-Cert Home Care, LLC v. Azar, CIVIL ACTION NO. 3:18-CV-2372-G
...keep its Medicare Provider Number Med-Cert only needs to provide services to one Medicare beneficiary every twelve months pursuant to 42 C.F.R. § 424.540(a)(1). Id. The defendants claim that Med-Cert can provide services to at least one beneficiary before this court decides Med-Cert's due p......
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Golden Home Health Care, LLC v. Verma, Case No. 2:20-cv-2954
...the Amended Complaint states that "ODM's decision to terminate Golden Home's Medicaid Provider Agreement is inconsistent with 42 C.F.R. § 424.540(c)," and violated Golden Home's due process rights under both the federal and state constitution. (Id. ¶¶ 62-63, 68.) Thus, the Amended Complaint......
2 firm's commentaries
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Medicare Enrollment: A Primer and How to Avoid Traps for the Unwary
...supporting documentation. § 424.515(a)(2). Failure to respond within ninety days is grounds for deactivation of billing privileges. 42 C.F.R. § 424.540(a)(3). [48] Program Integrity Manual, CMS Pub. 100-08, Ch. 15, § [49] 42 C.F.R. § 424.535. [50]42 C.F.R. § 424.535(c). [64] 42 C.F.R. § 424......
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Payment Matters: Reactivation of Billing Privileges – More Onerous for HHAs
...privileges. Since the June 2006 overhaul of the Medicare enrollment rules, CMS and its contractors have had the authority under 42 C.F.R. § 424.540(a) to deactivate Medicare billing privileges when: A provider or supplier fails to submit any Medicare claims during a 12-month time period, ......