Medicare Recertification

Beginning in 2012, providers began receiving notices on the new Medicare 855 enrollment process. As mandated under the Affordable Care Act, the 855 enrollment process now requires that Medicare providers revalidate their status and Medicare certification every five years. National Government Services (NGS) is the Medicare Administrative Contractor (MAC) for New York and they are responsible for issuing the requests for revalidation. Once the request is issued, failure to submit a timely 855 can result in a temporary suspension of Medicare payments.

A seemingly minor issue, but one that has caused significant problems for some LeadingAge New York members is that the request for revalidation is sometimes misdirected, resulting in a scramble and possible delay in completing the 855 process. The NGS database may not be up-to-date with changes in facility personnel and mailing addresses (hence the need for periodic revalidation), and the revalidation request can easily be lost in the mix of other NGS correspondence. 

A helpful solution now being offered by NGS is to mail the revalidation request in a bright yellow envelope and have posted a  “How to Identify Provider Enrollment Revalidation Letters in the Mail” feature on their website. Again, although a seemingly minor issue, it has caused some members significant problems. LeadingAge New York is grateful that NGS is sensitive to the issue and taking steps to assist providers. For more information and helpful hints on the 855 process, click here. Any personnel who may be handling NGS correspondence should be alerted to the priority handling of the revalidation request. 

CMS has also posted a list of all providers and suppliers sent notices during phase one. CMS will update this list every 60 days with a new group of providers and suppliers. 

Contact: Patrick Cucinelli, pcucinelli@leadingageny.org, 518-867-8827