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New
PECOS
Deadline
Set
Referring/ordering physicians
now face July 6th
deadline for enrollment
The AMA is reporting that the Centers for Medicare and Medicaid Services
(CMS) has published an Interim Final Rule requiring any physician who
refers or orders services (DMEPOS, home health, specialist services [not
defined by CMS], lab or imaging) to be enrolled with Medicare in the
PECOS system by July 6.
This includes any physician who has not submitted an updated enrollment
application to Medicare in the past six years or who has not reported
changes in their enrollment information that occurred during this time.
All physicians must list on their claims the legal name and National
Provider Identifier of the physician who referred/ordered to them for
services. If the referring/ordering physician is not enrolled in PECOS
by July 6, the physicians who receive the referral or order may have
their claims rejected. While this change stems from Section 6405 of the
Patient Protection and Affordable Care Act (PPACA), CMS went well beyond
the law when it issued the Interim Final Rule.
On May 28, the AMA along with 42 specialty societies sent a letter to
CMS calling for the agency to limit the July 6 date to those physicians
specifically named in the law: physicians who refer/order DMEPOS and
home health services. The letter urged CMS to allow physicians who
refer/order all other types of services to be permitted to enroll by
January 3, 2011, the date established by CMS prior to the passage of
PPACA. AMA has signaled that it will continue to urge CMS to revise the
July 6 requirement and limit it just to those named in the law.
For more AMA information on this issue, visit the “Medicare Enrollment”
section at
www.ama-assn.org/go/regrelief. To view
the lists of physicians with up-to-date enrollments, visit
http://www.cms.hhs.gov/MedicareProviderSupEnroll/Downloads/
OrderingReferringReport.pdf |
