BALTIMORE — After scrambling for months to make sure their referring and ordering physicians are enrolled in PECOS, DMEPOS providers will be able to use the Internet-based system to manage enrollment for themselves beginning in July, CMS officials announced last week.
"They can begin to use [the Provider Enrollment, Chain and Ownership System] to enroll, change enrollment or withdraw from the program beginning July 13," said Jim Bossenmeyer, director of CMS' Division of Provider/Supplier Enrollment, on a Special Open Door call May 19.
Instead of mailing CMS-855 paper forms, providers will be able to use the online system to enroll, complete the re-enrollment process and track the status of an application submitted through the Internet, as well as view the information CMS has on file for them, according to the agency.
Bossenmeyer had a caveat on the latter, however. "If you haven't updated your information since November 2003, PECOS will not have any information and you will be required to submit an application," he said.
According to CMS, on July 5 all active DMEPOS provider data from the National Supplier Clearinghouse will be transferred to PECOS.
"This move will establish enrollment records in PECOS for all active DMEPOS suppliers. PECOS currently contains the enrollment records for Medicare Part A and Part B fee-for-service providers and suppliers (with the exception of the DMEPOS suppliers). When the DMEPOS supplier enrollment records are moved into PECOS, PECOS will contain the enrollment information for all Medicare fee-for-service providers and suppliers," CMS says in its "Getting Started" guide about the system.
The agency is making the system accessible to DMEPOS providers now, although they will not be able to enroll or perform any other tasks until July 13. The idea, officials said, is to allow them to become familiar with the access procedures and features of the system.
Providers can access the system with the user IDs and passwords established when they applied to the National Plan and Provider Enumeration System for their National Provider Identifiers.
Bossenmeyer also said further information would be available at Wednesday's (May 26) regularly scheduled Open Door Forum for DMEPOS, home health and hospice. The call is scheduled for 2 p.m. ET. To listen in, call 800/837-1935 and reference conference ID 73237510.
CMS officials hit on a number of other issues during the call, but one particularly resonated with providers: the active date by which all Medicare physicians must be enrolled in PECOS. Bossenmeyer announced the compliance date as July 6; listeners, however, had heard from CMS that the implementation date was Jan. 3, 2011.
Stakeholders wondered if they submitted claims for items and/or services ordered after July 6 by a physician who was not enrolled in PECOS, would the claim be denied?
A North Carolina caller was the first of several to question Bossenmeyer in this exchange:
Caller: "I just wanted clarification on the
deadline ... and that is the July 6, 2010, deadline … please
correct me if I'm wrong, is [that] the PECOS enrollment deadline
for DME or is that the PECOS enrollment deadline for ordering and
referring that changed from Jan. 3 of 2011?"
Bossenmeyer: "The regulation is effective as of
July 6, 2010."
Caller: "So the regulation has come in, it's not
necessarily the implementation. The Jan. 3, 2011, date is still
valid."
Bossenmeyer: "Yes, ma'am."
Caller: "Thank you. You've made my day."
But providers remained confused by the two dates.
Mark Higley, vice president of development for Waterloo, Iowa-based VGM Group, acknowledged that the information was less than clear.
Higley said the recently-passed Patient Protection and Affordable Care Act stipulates physicians and eligible professionals who order items and/or services for Medicare beneficiaries must have an approved enrollment in PECOS. The sticking point, he said, is that the act's interim final rule has an effective date of July 1, and the CMS interim final rule "provides an effective date 60 days from its publication, which would be July 4, 2010." Written comments may, however, be submitted until July 6.
Since CMS had announced a delay of the PECOS edits (which require verification of a referral source's Medicare enrollment) until Jan. 3, 2011, Higley said he believes "that beginning July 4, if a claim is submitted for services in which the ordering or referring physician or eligible professional does not have a PECOS enrollment record, the provider or supplier submitting the claim will, as before the delay, receive a remittance with an informational message notifying the provider that the claim did not contain the requisite ordering/referring provider information … but will not be rejected."
"Bottom line: The 'drop dead' date remains Jan. 3, 2011," Higley said.
For further information on using the Internet-based PECOS, check CMS' "Getting Started" guide for DMEPOS providers. The guide includes a breakdown of the PECOS enrollment process for individual and organizational providers, step-by-step instructions on how to submit an online enrollment application, information on checking the status of an application and FAQs.
For information on the PECOS system from industry consultant Andrea Stark of MiraVista, see www.miravistallc.com/blog/?p=958.
