CMS delays PECOS

Sunday, November 29, 2009

WASHINGTON - To the relief of HME providers everywhere, CMS last week delayed for three months a new rule that requires ordering and referring physicians to register with its new Provider, Enrollment Chain and Ownership System (PECOS).

The rule will now go into effect April 5, 2010, according to a listserv message CMS sent out on Nov. 23.

HME providers have been in a panic about the rule. Initially, CMS planned to begin rejecting HME claims that included the names of unregistered physicians and non-physician practitioners Jan. 5, 2010.

AAHomecare lobbied CMS for the delay.

"We believe that unless CMS immediately delays the effective date, patient access to care and disruptions in provider payments will inevitably occur," the association stated in a recent letter to CMS Acting Administrator Charlene Frizzera.

AAHomecare got a delay, but not exactly on its terms. In its letter, the association requested a six-month delay. It pointed out that there are provisions in the healthcare reform bills in both the House of Representatives and the Senate that would require physicians to register with PECOS by July 1, 2010.

The association also requested that CMS "indefinitely suspend" HME claims rejections; develop and publish a corrective action plan that outlines how it will get physicians to register with PECOS; and release a list of physicians enrolled in PECOS "to allow suppliers to have sufficient time to review, analyze, offer recommendations to CMS, and program their billing systems to accommodate the applicable information accordingly."

"We're satisfied with the delay, but we still want to know how they plan to capture all the various doctors that prescribe HME," said Walt Gorski, vice president of government affairs for AAHomecare. "We will continue to work with CMS on this issue."

AAHomecare wasn't the only group to lobby for a delay. So did the American Medical Association (AMA), according to the National Association of Independent Medical Equipment Suppliers (NAIMES). The AMA and 56 other physician and clinical associations also sent a letter to Frizzera, NAIMES reported in a recent bulletin.

"Implementing this policy as scheduled will cut off access to care for millions of Medicare beneficiaries, interrupt reimbursement for legitimately provided items and services, interrupt care coordination, and add unfunded administrative mandates on a significant portion of physicians and other health care practitioners," the letter stated.

To read CMS's message in full, go here: