Medicare and Medicaid Enrollment and Revalidation: Obtaining and Maintaining Enrollment and Billing Privileges

Recording of a 90-minute CLE webinar with Q&A

Conducted on Wednesday, May 2, 2018

Recorded event now available

or call 1-800-926-7926
Program Materials

This CLE webinar will provide counsel to healthcare providers with crucial steps to successfully obtain and maintain their enrollment and billing privileges under the enhanced Medicare and Medicaid enrollment requirements.


The ACA enhanced the Centers for Medicare and Medicaid Services’ (CMS) enforcement authority by creating new requirements and sanctions for providers and suppliers participating in the Medicare and Medicaid programs and codifying existing regulations. And, since its enactment there has been increased scrutiny of adherence to the requirements, leading to adoption of additional regulations and far more aggressive enforcement.

The risk-based enrollment and revalidation screening procedures raise operational and administrative challenges for providers and increase the risk of deactivation or revocation of Medicare billing privileges or termination from the Medicare and Medicaid programs.

Counsel for healthcare providers must understand how CMS and the states implement the enrollment standards to advise clients on measures to take to obtain billing privileges, accurately revalidate program enrollment, and avoid compliance pitfalls.

Listen as our authoritative panel of healthcare counsel provides practical measures for complying with the new Medicare and Medicaid enrollment requirements to obtain and maintain enrollment and billing privileges.



  1. Enrollment
    1. Provider screenings—risk levels
    2. Other gatekeeping mechanisms
  2. Revalidation
  3. Enforcement measures
    1. Payment suspension
    2. Termination of provider participation
  4. Responding to notice of enrollment suspension or termination
  5. Appealing a termination or deactivation decision
  6. Corrective action plans—practical considerations when drafting


The panel will review these and other key issues:

  • What compliance best practices should providers use to increase the likelihood of meeting the enrollment requirements?
  • What approaches are most useful for responding to a notice of enrollment deactivation, revocation of billing privileges or termination?
  • How can providers appeal an enrollment revocation of billing privileges or termination decision?
  • Understanding the distinctions between the appeals process in an enrollment case versus an appeal of a claim’s determination or survey sanction.


Berg, Jesse
Jesse A. Berg

Gray Plant Mooty

Mr. Berg counsels healthcare providers on federal and state anti-kickback laws, the Stark physician self-referral law,...  |  Read More

Senft, Donna
Donna J. Senft

Baker Donelson Bearman Caldwell & Berkowitz

Ms. Senft focuses on health care transactions, Medicare enrollment and regulatory matters. She represents various...  |  Read More

Skeat, Kelly
Kelly J. Skeat

Benesch Friedlander Coplan & Aronoff

Ms. Skeat represents hospitals, physician practices, life science and durable medical equipment companies and private...  |  Read More

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