§ 424.525 Rejection of a provider's or supplier's application for Medicare enrollment. ( a ) *Reasons for rejection.* CMS may reject a provider's or supplier's enrollment application for any of the following reasons: ( 1 ) The provider or supplier fails to furnish complete information on the provider/supplier enrollment application within 30 calendar days from the date of the Medicare contractor's request for the missing information. This includes the following situations: ( i ) The application is missing data required by CMS or the Medicare contractor to process the application (such as, but not limited to, names, Social Security Number, contact information, and practice location information).
( ii ) The application is unsigned or undated.
( iii ) The application contains a copied or stamped signature.
( iv ) The application is signed more than 120 days prior to the date on which the Medicare contractor received the application.
( v ) The application is signed by a person unauthorized to do so under this subpart.
( vi ) For paper applications, the required certification statement is missing.
( vii ) The paper application is completed in pencil.
( viii ) The application is submitted via fax or e-mail when the provider or supplier was not otherwise permitted to do so.
( ix ) The provider or supplier failed to submit all of the forms needed to process a Form CMS-855 reassignment package within 30 days of receipt.
( x ) The provider or supplier submitted the incorrect Form CMS-855 application.
( 2 ) The provider or supplier fails to furnish all required supporting documentation within 30 calendar days of submitting the enrollment application.
( 3 ) The Prospective institutional provider or supplier does not submit the application fee in the designated amount or a hardship waiver request with the Medicare enrollment application at the time of filing.
( b ) *Extension of 30-day period.* CMS, at its discretion, may choose to extend the 30 day period if CMS determines that the provider or supplier is actively working with CMS to resolve any outstanding issues.
( c ) *Resubmission after rejection.* To enroll in Medicare and obtain Medicare billing privileges after notification of a rejected enrollment application, the provider or supplier must complete and submit a new enrollment application and submit all supporting documentation for CMS review and approval.
( d ) *Additional review.* Enrollment applications that are rejected are not afforded appeal rights.
( e ) *Applicability.* Except as otherwise specified in the applicable reason for rejection under paragraph (a) of this section, this section applies to all CMS Medicare provider enrollment application submissions, including, but not limited to, the following: ( 1 ) Form CMS-855 initial applications, change of information requests, changes of ownership, revalidations, and reactivations.
( 2 ) Form CMS-588 (Electronic Funds Transfer (EFT) Authorization Agreement) submissions.
( 3 ) Form CMS-20134 (Medicare Enrollment Application; Medicare Diabetes Prevention Program (MDPP) Suppliers) submissions.
( 4 ) Any electronic or successor versions of the forms identified in paragraphs (e)(1) through (3) of this section.
[71 FR 20776, Apr. 21, 2006, as amended at 73 FR 36461, June 27, 2008; 76 FR 5964, Feb. 2, 2011; 86 FR 62419, Nov. 9, 2021] Editorial Note
Editor's Note: At 86 FR 62419, Nov. 9, 2021, paragraph (a)(3) was amended by removing the phrase “prospective provider” and adding the word “provider” in its place; however, the phrase does not exist.