In an effort to address concerns expressed by the physician community, the Centers for Medicare and Medicaid Services (CMS) will not, for the time being, implement changes that would reject claims from physicians and other providers that did not have their enrollment applications in the Provider Enrollment, Chain and Ownership System (PECOS) approved by July 6, 2010. The agency's announcement comes as a result of physician organizations, including the AOA, calling on CMS to not go forward with the July 6 deadline. The AOA raised the concern that the July deadline could prevent Medicare beneficiaries from receiving the services and items they need.
The agency announced on June 30, that it is working with physicians and providers to address concerns about enrollment in PECOS, the electronic system used to enroll physicians and eligible professionals into the Medicare program. CMS did not specify when it would implement the deadline, however for now claims will not be automatically rejected based on orders, certifications and referrals made by physicians that have not had their applications approved. The agency also acknowledged problems with enrolling in PECOS and said it continues to update and streamline the process.
CMS issued an interim final regulation on May 5, 2010 implementing provisions of the Patient Protection and Affordable Care Act that permit only a Medicare enrolled physician or eligible professional to certify or order home health services, durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), and certain items and services under Medicare Part B. The new law applies to orders, referrals and certifications made on or after July 1. The agency will employ a contingency plan to meet the PPACA requirement that written orders and certifications are only issued by eligible professionals effective July 1.