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First Coast Service Options Inc.
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Last Modified: 4/1/2014 Location: FL, PR, USVI Business: Part B

Delegating authority to sign CMS-855B applications

Q: May an authorized official delegate their authority to sign CMS-855B applications?
A. An authorized official of an organization may delegate authority to make changes to enrollment information and to add physicians/practitioners. The organization must complete the section 16 of the CMS-855B and an authorized official must sign the certification statement. The delegated official must be an individual with an "ownership or control interest" in or be a W-2 managing employee of the supplier. The delegated official must be reported in Section 6.
An individual physician or practitioner cannot delegate authority and must sign the certification statement of the CMS-855I.
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Source: Medicare Program Integrity Manual, Chapter 10, Section 4.16

First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.