CMS Pub. 100-04, ch. 17, § 100.1.1

10 Calendar days after the end of the annual election period, the 2006 election period, by

May 25, 2006 A/B MACs (B) shall create a table and forward it to the designated A/B

MAC (B). The table will indicate which physicians have elected to participate in CAP,

for which drugs, and with which vendors. When A/B MACs (B) receive applications,

they shall verify that the chosen vendor is valid per the CMS Web site. If an invalid

vendor has been chosen, an educational contact shall be made to resolve the issue.

A/B MACs (B) shall forward this table each year to the designated A/B MAC (B) by

7calender days after the end of the election period. Should that date fall on a weekend, it

shall be extended to the following Monday.

The table shall include the physician’s name, the street address, city, state, zip code, and

phone number of each practice address/shipping address (the physical location where the

drugs will be administered and the CAP drugs shipped to), PIN, UPIN (or NPI when

effective), e-mail address (if available). If the mailing/correspondence address (where

the participating CAP physician can be contacted directly) is different from the

practice/shipping address, the mailing/correspondence shall be included. If the group or

individual practice has more than one practice location where drugs are administered,

each practice address/shipping location where drugs will be administered shall also be

included. For group practices that elect to participate in CAP, the group PIN as well as

the individual PINs and UPINs (NPI when effective) shall be included.

The A/B MACs (B) shall manually add any additional practice/shipping addresses and

the mailing/correspondence address to the spreadsheet provided to them by the shared

system before sending the information to the designated A/B MAC (B). A/B MACs (B)

shall also remove any members of a group practice who do not qualify to provide

services under the CAP. In order to qualify to provide services under the cap the

providers must have prescriptive authority in their state to prescribe medications.

Examples of provider types that may or may not have prescriptive authority in their states

are nurse practitioners and physician’s assistants.

Since group practices must commit as a practice to enroll in the CAP program if they bill

using the group’s PIN, if the A/B MAC (B) receives from the shared system names of

providers in a group for whom an election form has not been received, they shall contact

the group practice to verbally request the required election form information. A/B MACs

(B) shall only remove names from the CAP provider table when it has been determined

that the physician is no longer a member of a group practice. A/B MACs (B) shall not

allow a group practice to participate in the CAP until all election information has been

obtained for each eligible practice member within that group who bills using the group’s

PIN.

The designated A/B MAC (B) shall transmit information to each vendor on the

physicians and practitioners who have elected that particular vendor 30 days prior to the

start of the CAP year.