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医疗保险计划;医疗服务提供者和供应商建立及维持医疗保险参保资格的要求。最终规则。

Medicare program; requirements for providers and suppliers to establish and maintain Medicare enrollment. Final rule.

出版信息

Fed Regist. 2006 Apr 21;71(77):20753-81.

Abstract

This final rule requires that all providers and suppliers (other than physicians or practitioners who have elected to "opt-out" of the Medicare program) complete an enrollment form and submit specific information to us. This final rule also requires that all providers and suppliers periodically update and certify the accuracy of their enrollment information to receive and maintain billing privileges in the Medicare program. In addition, this final rule implements provisions in the statute that require us to ensure that all Medicare providers and suppliers are qualified to provide the appropriate health care services. These statutory provisions include requirements meant to protect beneficiaries and the Medicare Trust Funds by preventing unqualified, fraudulent, or excluded providers and suppliers from providing items or services to Medicare beneficiaries or billing the Medicare program or its beneficiaries.

摘要

本最终规则要求所有提供者和供应商(选择“退出”医疗保险计划的医生或从业者除外)填写注册表格并向我们提交特定信息。本最终规则还要求所有提供者和供应商定期更新并证明其注册信息的准确性,以便在医疗保险计划中获得并维持计费特权。此外,本最终规则实施了法规中的条款,要求我们确保所有医疗保险提供者和供应商有资格提供适当的医疗保健服务。这些法定条款包括旨在通过防止不合格、欺诈或被排除的提供者和供应商向医疗保险受益人提供物品或服务或向医疗保险计划或其受益人计费来保护受益人和医疗保险信托基金的要求。

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