Timely Filing Requirements for Medicare Fee-For-Service Claims
On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (PPACA), which amended the time period for filing Medicare fee-for-service (FFS) claims as one of many provisions aimed at curbing fraud, waste, and abuse in the Medicare program. The time period for filing Medicare FFS claims is specified in Sections 1814(a), 1835(a)(1), and 1842(b)(3) of the Social Security Act and in the Code of Federal Regulations (CFR), 42 CFR Section 424.44. Section 6404 of the PPACA amended the timely filing requirements to reduce the maximum time period for submission of all Medicare FFS claims to one calendar year after the date of service. Under the new law, claims for services furnished on or after January 1, 2010, must be filed within one calendar year after the date of service. In addition, Section 6404 mandates that claims for services furnished before January 1, 2010, must be filed no later than December 31, 2010. The following rules apply to claims with dates of service prior to January 1, 2010. Claims with dates of service before October 1, 2009, must follow the pre-PPACA timely filing rules. Claims with dates of service October 1, 2009, through December 31, 2009, must be submitted by December 31, 2010. Section 6404 of the PPACA also permits the Secretary to make certain exceptions to the one-year filing deadline. At this time, no exceptions have been established. However, proposals for exceptions will be specified in future proposed rulemaking. Please be on the alert for more information pertaining to the Patient Protection and Affordable Care Act. ________________________________________________________________________ _____________________ If you received this message as part of the All FFS Providers listserv, you are currently subscribed to one of eighteen Medicare Fee-For-Service (FFS) provider listservs. If you would like to be removed from all NIH listservs, please go to (https://list.nih.gov/LISTSERV_WEB/signoff.htm <https://list.nih.gov/LISTSERV_WEB/signoff.htm> ) to unsubscribe. If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/show_list_archives <https://list.nih.gov/cgi-bin/show_list_archives> ) to unsubscribe or to leave the appropriate listserv. If you know someone who would like to subscribe to a FFS provider listserv, go to (http://www.cms.hhs.gov/prospmedicarefeesvcpmtgen/downloads/Provider_Lis tservs.pdf) . Please DO NOT respond to this email. This email is a service of CMS and routed through an electronic mail server to communicate Medicare policy and operational changes and/or updates. Responses to this email are not routed to CMS personnel. Inquiries may be sent by going to (http://www.cms.hhs.gov/ContactCMS <http://www.cms.hhs.gov/ContactCMS> ). Thank you.
