SLPs and AUDs Must Revalidate Medicare Enrollment or RiskLosing Billing Privileges:
MSHA members who are enrolled as Medicare providers need to pay special attention to the following ASHA Headline posted August 17, 2011 by
SLP and Audiology Medicare Providers Must Revalidate Enrollment
All speech-language pathologists (SLPs) and audiologists who enrolled in Medicare prior to Friday, March 23, 2011, will need to revalidate
their enrollment at some point between now and March 2013. This is due to new risk screening criteria required under the Affordable Care Act (ACA) which was
implemented by the Centers for Medicare and Medicaid Services (CMS) in March 2011. The new risk screening criteria places providers and suppliers in one of
three screening categories – limited, moderate, or high. These categories represent the level of risk to the Medicare program and determine the degree of
screening that will be done by the Medicare Administrative Contractor (MAC) processing the enrollment application that will be submitted for revalidation.
SLPs and audiologists enrolled as individuals or group practices are placed in the limited category. The enrollment process for providers and suppliers in the
limited category remains unchanged.
Between now and March 2013, MACs will send revalidation requests to individual providers and suppliers enrolled in Medicare. SLPs and
audiologists should submit complete enrollment forms to their MAC within 60 days of the revalidation request. An SLP or audiologist who does not submit
enrollment forms as requested may lose Medicare billing privileges. CMS encourages providers and suppliers to revalidate enrollment information by
using Internet-based PECOS (Provider Enrollment, Chain, and Ownership System), at https://pecos.CMS.hhs.gov.
More information about provider revalidation can be found in the Medicare Learning Network’s Special Edition Article #SE1126, titled,
“Further Details on the Revalidation of Provider Enrollment Information,” or the Medicare Program Integrity Manual, Chapter 15, section 15.19.2. Further
questions may be directed to Kate Romanow, ASHA’s director of health care regulatory advocacy, by e-mail at firstname.lastname@example.org or Mark
Kander, ASHA’s director of health care regulatory analysis, at email@example.com.
Lemmietta G. McNeilly, PhD, CCC-SLP, CAE, ASHA Fellow
Chief Staff Officer, Speech-Language Pathology
American Speech-Language-Hearing Association
2200 Research Boulevard, #229
Rockville, MD 20850-3289
+1 301-296-5705 telephone
The MSHA Healthcare Committee would like to monitor how this issue affects its members. Please send feedback
during the Medicare revalidation process to firstname.lastname@example.org.
-Christine D. Gibson, MSHA VP Healthcare