Report Changes to your Enrollment Records

You must report changes of information in your Medicare enrollment records within 30 days for:

• Change(s) in ownership or control, including changes in authorized officials(s)
• Change(s) in practice location
• Final adverse legal action(s)
• IDTF supplier change(s) in general supervision
• MDPP supplier change(s) in coach roster

All other changes to your existing Medicare enrollment records must be reported within 90 days.

The request may be submitted no more than 60 days prior to the effective date of the change reported on the application.

Reminder: Terminate reassignments and employment arrangements timely.

Related Content

• MLN Matters® SE1617:Timely Reporting of Provider Enrollment Information Changes
• Centers for Medicare & Medicaid Services Internet-Only Manual Publication 100-08, Medicare Program Integrity Manual, Chapter 10, Section 10.2.2 (I) (2) & 10.2.6.(C), 10.3.2(A)(1)(f)(iii), 10.4.(J) & 10.7.15(B)

Revised 4/8/2021