CMS, NPE contractors implement enrollment changes

WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) recently implemented changes that it says will streamline the DMEPOS enrollment process, according to a bulletin from Novitas Solutions, the National Provider Enrollment (NPE) contractor for the East. For applications submitted on or after May 18, 2026, NPEAST will conduct a preliminary review within 10 calendar days of receipt. This review includes items such as exclusion checks, ownership review and accreditation verification (if applicable). Based on this review, fingerprinting and/or an unannounced site visit may be required early in the process. Suppliers should expect, in most cases, a single, comprehensive development request if additional information is needed. When issued, suppliers will generally have 30 calendar days to respond. In some situations, CMS may place a supplier into a Stay of Enrollment status. A stay is a temporary pause in enrollment activity and is not a revocation or deactivation. During a stay, the supplier remains enrolled in Medicare but must resolve the outstanding issue within the required timeframe. If a complete response is not provided, the NPE may take further administrative action (such as deactivation or revocation). If a supplier does not respond to a development request for these application types, a Stay of Enrollment may be applied for up to 30 days. If the issue is not resolved during the stay period, further administrative action (such as revocation) may occur. For initial enrollments or reactivations, failure to respond to development generally results in denial or rejection, and a Stay of Enrollment does not apply. CMS has also established a Stay of Enrollment process for certain standalone surety bond or liability insurance cancellations. In these situations, a temporary stay may be applied to allow time to resolve the issue when no other enrollment deficiencies are present. Suppliers are encouraged to promptly submit updated, valid certificates to avoid disruption. According to the bulletin, suppliers can support timely processing by:

• Carefully reviewing the CMS-855S documentation checklist before submission
• Ensuring all information in PECOS (or paper applications) is complete and current
• Preparing in advance for unannounced site visits
• Completing fingerprint requirements as soon as requested