You have at least a 93% chance of being required to revalidate a physician, nurse practitioner or physician assistant by March 23, 2013. Physicians make up the bulk of providers who need to be revalidated as part of CMS’s new enrollment revalidation drive, which affects all providers who enrolled before March 25, 2011. Nearly 52% of these folks are physicians, according to a draft CMS statement-of-work document released May 27. Non-physicians make up the next biggest segment, representing 20.8% of the pie.
Remember: The revalidation initiative is intended to subject all providers enrolled in Medicare to a new screening process that was implemented as part of the health reform law. The new screening process was implemented on all applications starting March 25, which means providers enrolled on or after that date have already been subjected to the process and aren’t impacted by the 2013 revalidation effort.
Still, as the chart shows, CMS is projecting that a total of more than 1.4 million providers nationwide will have to revalidate by 2013. For physicians, CMS projects 750,836 individuals will need to revalidate – a huge number when you consider that only 932,737 physicians and non-physician practitioners were enrolled to participate as of January 2010, according to CMS’s own data compendium figures. NOTE: The CMS data compendium and the CMS statement-of-work documents seem to use different definitions of “non-physicians.” Thus the 932,737 figure seems small when the statement of work claims that 300,362 non-physicians, plus 750,836 physicians, must revalidate.
Bottom line: If you count physicians and nurse practitioners/physician assistants, you get a total of roughly 872,000 providers needing to revalidate. Compare this to the compendium data and you see that 93% of all physicians and NPs/PAs participating in Medicare will need to revalidate, based on CMS’s own data.