June 30, 2010
The Centers for Medicare & Medicaid Services (CMS) is working to address concerns about the impending July 6, 2010, deadline for enrollment in the Provider Enrollment, Chain and Ownership System (PECOS), the electronic system used to enroll physicians and eligible professionals into the Medicare program. The goal of the PECOS regulation is to help prevent Medicare fraud by ensuring that only eligible and identifiable providers and suppliers can order and refer covered items and services to Medicare beneficiaries.
CMS announced June 30, 2010, that for now, the Agency will not automatically reject claims based on orders, certifications, and referrals made by providers that have not yet enrolled and been approved in the PECOS system. CMS notes that while more than 800,000 physicians and other health professionals have enrolled and have approved applications in the PECOS system, some providers have encountered problems.
It is important to note that the CMS regulation requiring enrollment in PECOS will still take effect July 6, 2010, but CMS will not implement automatic rejections of claims submitted by providers that have attempted to enroll in PECOS by the July 6, 2010, deadline. Until the automatic rejections are operational, providers should not see any change in the processing of submitted claims.
CMS will continue to send notices to providers reminding them of the need to submit or update their enrollment information in the PECOS system.
ABC urges you to act soon to complete the PECOS enrollment process.
Dr. Roquell Wyche,
ABC Advocacy Chair