Posted in the AOPA Insider on June 3, 2010:
BREAKING NEWS: PECOS implementation date moved up to July 6, 2010
AOPA in Advance
The Centers for Medicare and Medicaid Services (CMS) has published an
interim final rule that changes the date by which referring physicians
must have active accounts in the Provider Enrollment Chain and
Ownership System (PECOS) from Jan. 3, 2011 back to July 6, 2010.
According to Jim Bossenmeyer from CMS, the earlier implementation date
is a requirement of provisions contained in the Patient Protection and
Affordable Care Act (PPACA) passed earlier this year. In order for a
physician or other qualified healthcare practitioner referral or order
to be considered valid for Medicare claim submission purposes, it must
come from a provider with a current PECOS enrollment record.
Originally scheduled for implementation on Jan. 4, 2010, the PECOS
requirement has been delayed several times in order for CMS to develop
proper system edits to properly enforce it. While Bossenmeyer stated
in a May 26, 2010 CMS Open Door Forum that PECOS system edits may not
be fully functional by July 6, 2010, CMS reserves the right to
reprocess claims that should not have been paid due to an invalid
referral once the edits are fully functional. The four DME MACs are
continuing to generate warning notices when services are referred by
physicians who do not have a current PECOS record. It is important to
continue to remind your referral sources that in order to continue to
refer Medicare beneficiaries for services, they must be enrolled in
PECOS by July 6, 2010. Questions about this issue should be directed
to Joe McTernan at [email protected], Devon Bernard at
[email protected], or Kathy Dodson at [email protected].
You can find information about Internet-based PECOS and a link to
Internet-based PECOS at www.cms.hhs.gov/MedicareProviderSupEnroll
A free PECOS search has been made available at www.oandp.com. The database
search is up to date and will allow you to find out if your referring
physicians have registered with PECOS or not. To find out more, refer to the
following press release:
http://www.oandp.com/articles/news_2010-02-12_02.asp
—
Randy Loya, LAT
Account Manager
Central Texas Orthotics & Prosthetics, LP
