CMS TO REVIEW PECOS ENROLLMENT PROCESS: Medicare Working with Ordering and Referring Providers and Suppliers to Streamline Enrollment Process

CMS is working with providers to address concerns about enrollment in the Provider Enrollment, Chain and Ownership System (PECOS) to ensure that Medicare beneficiaries continue to receive the health care services and items they need.  PECOS is the electronic system used to enroll physicians and eligible professionals into the Medicare program.

As part of those efforts, CMS will, for the time being, not implement changes that would automatically reject claims based on orders, certifications, and referrals made by providers that have not yet had their applications approved by July 6, 2010.   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.  CMS is continuing to update and streamline the process, and more providers have been enrolled in the past few days.

  The new law applies to orders, referrals and certifications made on or after July 1.  The comment period for the regulation closes on July 6, after which the comments will be reviewed and considered before a final regulation is issued. 

While the regulation will be effective July 6, 2010, CMS will not implement automatic rejections of claims submitted by providers that have attempted to enroll in PECOS.