Medicare Claims Processing Manual (Pub. 100-04), Ch. 19 § 40.2
Provider Enrollment with A/B MAC (A)
40.2 - Provider Enrollment with A/B MAC (A)
(Rev. 1040, Issued: 08-25-06, Effective: 09-11-06, Implementation: 09-11-06)
New IHS providers, including Critical Access Hospitals (CAHs) follow the same
application process as any other provider enrolling in Medicare with the designated A/B
MAC (A). Instructions for completing the Form CMS-855A, Application for Health Care
Providers that will bill Medicare A/B MACs (A) are found in Pub. 100-08, Medicare
Program Integrity Manual, Chapter 10.
Section 1865 of the Social Security Act and pursuant regulations provide that IHS
owned/tribally operated and IHS owned/operated facilities accredited by the Joint
Commission of Accreditation of Healthcare Organization (JCAHO) or the American
Osteopathic Accreditation (AOA) are deemed to meet the Medicare Conditions of
Participation (COPS). A Federal survey is required for facilities without JCAHO or AOA
accreditation.
Tribally owned and operated facilities are generally under the state survey agency
jurisdiction. However, the state or the tribe may request that the survey be conducted by a
Federal surveyor.
Freestanding FQHCs enroll with the designated FQHC A/B MAC (A).