Stay of enrollment

A provider or supplier may have a stay of enrollment implemented if they are deficient in a provider enrollment requirement which can be remedied by submitting a provider enrollment application. A stay of enrollment is a preliminary, interim status representing a pause in enrollment.

During a stay of enrollment, (or stay), the provider or supplier will remain active in Medicare, but we will reject any claim submitted with a date of service within the stay period. The stay of enrollment will not last more than 60 days. 

Some examples of when a stay of enrollment may be implemented:

• Provider failed to timely report a change in address
  

• Supplier didn't respond to a revalidation request
  

• Independent diagnostic testing facility failed to comply with a supplier standard
  

• A supplier failed to timely report a change in address of an organizational owner
  

• A supplier failed to report the deletion of a managing employee
• A supplier failed to respond to a development request for either a change of information or revalidation application

Note: If there is a non-compliance issue that cannot be corrected by the submission of a provider enrollment application, a stay of enrollment will not be imposed, but addressed by other means.

If a stay of enrollment has been placed on your enrollment record, you will be notified by hard-copy mail, e-mail (see update below), and fax, if applicable. To have the stay of enrollment removed, the non-compliance issue must be resolved by submitting the applicable Medicare application.

For example: A clinic group practice recently changed practice locations and did not notify Medicare. A stay of enrollment was implemented because a change in practice location was not reported. To have the stay of enrollment removed and be able to continue billing Medicare,  submit a change of information enrollment application to update the practice address. 

Update: Providers have reported that stay of enrollment letters have been found in their spam folder when sent via email. Please ensure your spam folder is monitored for any provider enrollment correspondence.

If you believe all provider enrollment requirements have been met and the stay of enrollment should not have been imposed, submit a provider enrollment rebuttal. Refer to the stay of enrollment letter for instructions on how and where to submit the rebuttal.

For more information, please review:

MLN Matters article MM13449, Stay of enrollment