PECOS: Providers step on the gas

Thursday, January 14, 2010

WASHINGTON - When it comes to the new Provider Enrollment, Chain and Ownership System (PECOS), HME providers feel they're holding up their end of the bargain, but Medicare officials aren't holding up theirs.

Providers reported last week that they were hosting numerous in-services to educate ordering and prescribing physicians about the need to register with PECOS by April 5, 2010.

"Whenever I fax an evaluation to be signed by a physician, I'm also sending another sheet that asks, 'Are you registered with PECOS?' and explains the requirement," said Cindi Petito, an occupational therapist and owner of Seating Solutions in Jacksonville, Fla.

When Medicare officials delayed the requirement in November, they promised to do two things to make the whole process easier for physicians and providers: 1.) Update the records of physicians registered with PECOS to include their NPI numbers; and 2.) Provide a searchable database of compliant physicians.

At press time last week, neither had happened yet.

"There's so much riding on that," said Andrew Stark, founder of MiraVista, a consulting firm in Columbia, S.C.

Here's why: When Medicare officials crosswalk PECOS and NPI information, they'll significantly reduce the number of warning messages that providers receive about non-compliant physicians. (After April 5, those warnings will become denials.) When they provide a database, they'll make it easier for providers to know where to focus their education efforts.

"Right now, it's like we have to blanket everybody," said Jeff Carr, president of Carr Rehab in Knoxville, Tenn.

Even when providers succeed in getting the attention of physicians, there are problems. Providers report the process is time consuming for physicians (one physician has been working on it since October) and confusing (a group practice registered with PECOS only to learn that each of its physicians must do it individually).

Providers say all of these issues--not to mention that physicians have no real incentive to register with PECOS, because Medicare will stop payments to HME providers, not to them--could warrant another delay, but probably not until after the April 5 deadline.

"What's going to happen when you have an oxygen patient that needs to go home from a hospital and the attending physician is not registered with PECOS?" Carr asked. "The HME provider has to say, 'Sorry, we can't help you.' When those types of scenarios start to happen, we may see another delay."