Reporting by Physicians Enrolled in Medicare

Physicians enrolled in Medicare are required to report to Medicare the following events as soon as possible, but not later than 30 days following the event:

Change in Practice Location: A change in practice locations including, but not limited to  a new practice location, moving an existing practice location, or closing an existing practice location must be reported.

Change in Final Adverse Action: A change including, but not limited to, debarment or exclusion by a federal or state health care program, medical licensure suspension or revocation by a licensing board, conviction of a felony in the last 10 years, or revocation of Medicare privileges must be reported.

Physicians enrolled in Medicare are required to report to Medicare the following events as soon as possible, but no later than 90 days following the event:

Change in Business Structure: A change in business structure, for example, from a sole proprietor to a corporation must be reported.

Change in Legal Business Name or Employer Identification Number: A change in a company legal business name or IRS Employer Identification Number must be reported.

Change in Practice Status: A change in practice status including, but not limited to, retirement or voluntarily withdrawal from Medicare must be reported.

There are other reportable events.  Failure to timely report a reportable event may jeopardize a physician’s participation in Medicare.

If you have a question concerning your responsibilities to report a particular event to Medicare, contact Todd Collis or Beth Collis.

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