Provider Enrollment Handout - Palmetto GBA

PE Provisions: BeginningMarch 25, 2011□ Establishes provider enrollment screeningcategories□ Submission of application fees as part of theprovider enrollment process□ Suspensions of payment based on credibleallegations of fraud□ Authority to impose a temporary moratoriumon the enrollment of new Medicareproviders and suppliers of a particular type(or the establishment of new practicelocations of a particular type) in ageographic areaScreening Process□ Medicare will place newly-enrollingand existing providers and suppliers inone of three levels of categoricalscreening:□ Limited□ Moderate□ HighSpeaker Note : Chapter 15, Section 19.2.1 of the “Program Integrity Manual” (PIM) provides thecomplete list of these three screening categories, the provider types assigned to each category, and adescription of the screening processes applicable to the three categories, and procedures to be usedfor each category.20