The Centers for Medicare and Medicaid Studies (CMS) requires Medicare contractors to conduct monthly reviews of state licensing board actions to determine:
- If an individual healthcare practitioner continues to meet all state licensure requirements, and
- If an organizational entity continues to meet all federal and state licensure requirements for its specific healthcare provider or supplier type.
If a Medicare provider or supplier fails to report an adverse action (i.e. license revocation) within 30 days, that provider’s or supplier’s billing privileges may be revoked.