The Centers for Medicare and Medicaid Services (CMS) have published the final rule establishing the enrollment requirements for participation in Medicare. The proposed rule was published on April 25, 2003. There are no significant surprises in the final rule, which does the following:

1.Establishes the basic enrollment requirements regarding the content of the application, state licensing, prior federal program exclusions and felonies, etc.;

2.Requires recertification on a five-year basis;

3.Reserves the right for Medicare to conduct an onsite inspection and require off cycle re-credentialing when warranted;

4.Provides that Medicare participation may be deactivated if there is no billing activity during a twelve-month period; and

5.Specifically confirms that providers may not sell, assign or otherwise allow other third parties to use their billing numbers.

The final rule will become effective on June 30, 2006. It can be viewed in the April 21, 2006 edition of the Federal Register beginning at page 20,754 and will be included in the Code of Federal Regulations at 42 CFR §§ 424.500 – 424.555.