The deadline for physician and non-physician practitioners to register in the Internet-based Provider Enrollment Chain and Ownership System (PECOS) has been delayed from April 5 to Jan. 3, 2011. This is the second implementation delay by the Centers for Medicare & Medicaid Services (CMS).
“The delay … will give physicians and non-physician practitioners who order items or services for Medicare beneficiaries or who refer Medicare beneficiaries to other Medicare providers or suppliers, sufficient time to enroll in Medicare or take the action necessary to establish a current enrollment record in Medicare prior to Phase 2 implementation,” Peter Ashkenaz, deputy director of media relations at CMS told O&P Business News.
Dale Cohen, CPed at George Allen Shoes, spoke of relief when he was informed of CMS’ additional delay. Cohen created a list of doctors that would not be eligible to write DME prescriptions beginning in October 2009, the same month CMS began to send informational messages to orthotic, prosthetic and pedorthic practitioners. He estimated the list had reached 20 to 30 names, as of press time.
“Multiply that by the entire O&P community and you can see there would have been big problems,” Cohen said.
CMS recently created a downloadable file with a list of doctors enrolled in Internet-based PECOS. The problem, according to Cohen, is that the database is 13,000 pages and is not efficient.
“It is still a mess,” Cohen admitted. “The new delay at least ensures that I will be in business for another year. Can you imagine the uproar if we start filling prescriptions for braces, shoes or walkers for patients and then we don’t get paid? That would put people out of business in a month or two.”
Although PECOS has become common knowledge within the O&P and pedorthic industries, Cohen has found it difficult to get the message through to the doctors.
“We call the doctor’s offices and the assistants do not know what we are talking about,” Cohen said. “That is a brick wall.”
Cohen strongly suggested that CMS take a pro-active role in notifying doctors.
“The problem is CMS and how they are communicating with the physicians,” he said. “They need to send a letter or note or call the doctor’s office directly. The physicians do not care if an O&P guy calls them. They need to get something official from Medicare.”
The delay will give CMS more time to direct education and outreach efforts to practitioners who still need to update their Medicare enrollment records.
“Since physicians and eligible non-physician practitioners will have had more than 15 months to update their Medicare enrollment record, we do not expect that there will be any additional delays in implementation,” Ashkenaz said. “To ensure payment accuracy, we believe that all providers and suppliers, including physicians and non-physician practitioners, should keep their Medicare enrollment record up-to-date and report changes as they occur.”
Cohen is less confident.
“I believe it is going to be a mess,” Cohen predicted. — by Anthony Calabro
For more information:
- Centers for Medicare and Medicaid Services. Ordering referring report. Available at: http://www.cms.hhs.gov/MedicareproviderSupEnroll. Accessed Feb. 24, 2010.
