CMS Payment to Beneficiaries – Regulatory Requirements

9055.3 – CMS Payment to Beneficiaries – Regulatory Requirements (Rev. 24, Issued: 02-12-16, Effective: 03-14-16, Implementation: 03-14-16) If a beneficiary submits claims for items or services furnished or ordered by an excluded practitioner or other person on or after the effective date of exclusion, CMS will make payments as follows: 1. The first claim for payment of benefits covered under Medicare Part B the beneficiary submits will be paid, and the beneficiary will be immediately notified of the exclusion. 2. The beneficiary's right to payment will extend to items or services the excluded practitioner or other person furnished or ordered up to 15 days after the date on the exclusion notice, or after the effective date of the exclusion notice, whichever is later.