title: Medicare program; requirements for the Medicare incentive reward program and provider enrollment. Final rule.
abstract: This final rule implements various provider enrollment requirements. These include: Expanding the instances in which a felony conviction can serve as a basis for denial or revocation of a provider or supplier's enrollment; if certain criteria are met, enabling us to deny enrollment if the enrolling provider, supplier, or owner thereof had an ownership relationship with a previously enrolled provider or supplier that had a Medicare debt; enabling us to revoke Medicare billing privileges if we determine that the provider or supplier has a pattern or practice of submitting claims that fail to meet Medicare requirements; and limiting the ability of ambulance suppliers to "backbill" for services performed prior to enrollment.
mesh_terms: D005607:Fraud / Q000331:legislation & jurisprudence; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics* / Q000331:legislation & jurisprudence*; D006278:Medicare / Q000191:economics* / Q000331:legislation & jurisprudence*; D012052:Reimbursement, Incentive / Q000191:economics* / Q000331:legislation & jurisprudence*; D014481:United States