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How does CMS conduct the verification of professional liability/malpractice coverage?

User Zeel
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Final answer:

CMS verifies malpractice coverage by asking healthcare providers to provide insurance information during credentialing processes, and may require additional documentation such as insurance certificates or declarations to confirm coverage details and compliance.

Step-by-step explanation:

The Centers for Medicare & Medicaid Services (CMS) follows specific procedures to verify professional liability or malpractice coverage. Typically, CMS requires healthcare providers to disclose their professional liability insurance on credentialing and recredentialing applications. Some of the methods CMS might use for verification include requesting a copy of the insurance certificate, asking for a policy declaration page, or using a database that tracks malpractice coverage. More detailed verification procedures might require providers to submit a statement from their insurance carrier confirming the coverage details, policy limits, and the effective period. It's important for healthcare providers to maintain up-to-date records of their professional liability insurance to remain in compliance with CMS regulations and to ensure continued eligibility for participation in Medicare and Medicaid programs.

User Roman Golenok
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