PECOS Delayed to 2011
CMS pushes out registration requirement to Jan. 3, 2011.
- By David Kopf
- Feb 19, 2010
Facing multiple enrolment difficulties, CMS said in this week’s Open Door Forum call that it would that it will push the implementation deadline for its Provider Enrollment, Chain and Ownership System from April 5 to Jan. 3, 2011.
The agency said providers will still receive updates on PECOS and warnings regarding non-enrolled physicians, and CMS will make updates to the physician records periodically.
“An update to change requests 6417 and 6421 is expected to be released in the near future,” says Andrea Stark, DME consultant with HME consulting firm MiraVista LLC. “In the meantime, suppliers will continue to receive warning messages on their GenResponse reports and should continue their efforts to get physicians enrolled. Remember, this is not the death of PECOS, only a delay.”
CMS stated on the call that the Part B MACs will send a revalidation letters to all physicians who have not updated their Medicare enrollment in more than six years, telling them to re-enroll in PECOS. The letter will instruct the physician to submit either an updated paper enrollment form or to go online and enroll in PECOS.
Sneak Attack
Providers were initially ambushed by the then virtually unknown program in October, when they began receiving warnings that claims for DME coming from referring physicians and other referring healthcare professionals not registered in the PECOS registry by Jan. 5, 2010 would not be funded. Other processionals include nurse practitioners, physician assistants, social workers, psychologists, and physical therapists.
To further frustrate matters, ensuring those physicians and other referring healthcare professionals were registered in the system was left largely to HMEs.
The American Association met with CMS and issued a formal letter to the agency to communicate provider concerns about the extremely tight deadline and how it would impact their businesses and patient access to DME. When it became clear in early December that not nearly enough physicians were registered in the system and that less than two months was not adequate time to get them registered, CMS delayed until April 5 implementation of phase 2 of change requests 6417 and 6421 that would have blocked funding for DME ordered from physicians and other healthcare professional not registered with CMS’s Provider Enrollment, Chain and Ownership System (PECOS).
To help providers urge their referral partners into the system, CMS released in late January a 13,500-plus-page PDF listing of nearly 800,000 physicians and healthcare professionals registered in the system. Providers were left to sift through the list using a simple CTR-F “find” to see if their referral partners were listed or not. Two weeks ago, software tools started emerging from vendors such as Fastrack Healthcare Systems and Physicians Filing Service Inc. to help providers better sort through the unwieldy listing, but the task of getting all referral partners registered within the tight scheduled seemed ominous at best.
Ongoing FIght
So, the industry continued striving to delay the registration deadline past April 5. The AAHomecare State Leaders’ Advisory Council developed a survey that documented the extent of the PECOS problems, and the association met with and communicated with CMS multiple times a week to demonstrate how PECOS would harm providers and patients.
Additionally, AAHomecare worked with the American Medical Association (AMA) and the physician community to seal a delay to PECOS.
“We are getting plenty of calls and emails from physicians saying they are not able to get through to customer service lines like PECOS if they have a question,” An AMA representative said. “There are long wait times to get through and general problems getting applications processed.”
“PECOS is a classic example of the documentation and administrative burden that is part of doing business with Medicare,” said AAHomecare president Tyler Wilson. “In many cases, the rules and regulations create almost impossible demands for filing claims. AAHomecare was a pit bull in fighting this issue through our contacts with CMS and I am glad to see the agency pull back from the brink of implementing such an impractical requirement.”
AAHomecare said it will push CMS to publicize PECOS requirements with physicians similar to the way it handled the National Provider Identifier (NPI) number issue. During the NPI start-up process, CMS sent out public announcements several times each week, the association said.
“Ideally, we would like to see some sort of requirement that ties physicians to the PECOS enrollment process,” said Walt Gorski, AAHomecare’s vice president for government affairs. “Their claims were not in jeopardy, but ours were. The burden should not be placed on the HME provider to press physicians to enroll. Nevertheless, this is an excellent outcome.
“We greatly appreciate the work of the AAHomecare State Leaders’ Advisory Council for developing a PECOS survey to document the extent of the PECOS problems,” Gorski continued. “The delay of implementation of PECOS edits and claims rejections demonstrate the importance of advocacy and action within the home medical equipment sector and also the value of collaboration with other health sectors.”
About the Author
David Kopf is the Editor of HME Business.