DCE Notice to TINs. By a date specified by CMS, the DCE shall furnish written notification to the executive of any TIN through which an individual or entity on the Proposed Revised DC Participant Provider List or Proposed Revised Preferred Provider List bills Medicare. Such notification must:
1. Include a list identifying by name and NPI each individual or entity that will be identified on the DCE’s Proposed Revised DC Participant Provider List or Proposed Revised Preferred Provider List as billing through the entity’s TIN; and
2. Inform the executive of the TIN that a DC Participant Provider’s participation in the DCE may preclude the entire TIN from participating in the Medicare Shared Savings Program and any other Medicare initiative that involves shared savings and identifies participants by an entire TIN.
3. Inform the executive of the TIN that a DC Participant Provider’s participation in the DCE may preclude the TIN/NPI combination associated with that individual or entity from participating in the Kidney Care Choices Model, Vermont Medicare ACO Initiative, another Medicare DCE in the Model, any other Medicare initiative that involves shared savings and identifies participants by a TIN/NPI combination (except as otherwise specified by CMS), the Maryland Total Cost of Care Model, Primary Care First Model, and the Independence at Home Demonstration.
4. Inform the executive of the TIN that a Preferred Provider’s participation in the DCE may preclude the TIN/NPI combination associated with that individual or entity from participating in the Maryland Total Cost of Care Model.
DCE Notice to TINs. By a date specified by CMS, the DCE shall furnish written notification to the executive of any TIN through which an individual or entity on the Proposed Revised DC Participant Provider List or Proposed Revised Preferred Provider List bills Medicare. Such notification must:
1. Include a list identifying by name and NPI each individual or entity that will be identified on the DCE's Proposed Revised DC Participant Provider List or Proposed Revised Preferred Provider List as billing through the entity's TIN; and
2. Inform the executive of the TIN that a DC Participant Provider's participation in the DCE may preclude the entire TIN from participating in the Medicare Shared Savings Program and any other Medicare initiative that involves shared savings and identifies participants by an entire TIN.
