The Centers for Medicare & Medicaid Services (CMS) requires providers to submit claims electronically, unless they meet an Administrative Simplification Compliance Act (ASCA) exception and have an ASCA waiver form on file with their Medicare Administrative Contractor (MAC). To meet CMS requirements, National Government Services launched an ASCA review beginning 07/31/14 for some JK Part B providers in Connecticut and New York. If you have not received a letter, you are not under review at this time.

If you have received an ASCA review letter, it is important that you respond timely. If no response is received by the 91st day of the initial letter, your ability to submit paper claims will cease.

ASCA waivers are only valid for two years. Providers under this review met one or more of the following criteria:

  • Previously was determined as a small provider "SM" however; that provider submitted a significant volume of paper claims and it has been two years or more since their waiver was granted.
  • Was issued a "WA" or "UC" waiver that is two years old or more.
  • Is submitting more than 30 claims per quarter and has never been under ASCA review.

Processing of waiver requests takes 30 days once received; questions regarding status of waivers should not be sent until the 30 days has elapsed. Questions regarding ASCA waivers should be directed to the Provider Contact Center at 866-837-0241. Note: Documentation is required for all ASCA waiver requests. Failure to submit valid/current documentation may result in a denial of the waiver request.

Detailed ASCA information is available on our website under the Claims tab.