PECOS: 'We think a delay has to happen'

Sunday, November 15, 2009

WASHINGTON - CMS's PECOS program appears to be turning into the nightmare that HME providers feared all along.

While CMS has released no official data, AAHomecare estimates that between 40% and 90% of physicians (the number varies from provider to provider) have not completed the Provider Enrollment, Chain and Ownership System (PECOS) registration process.

Those numbers are huge because come Jan. 5, 2010, claims for DME will be denied if the prescribing physician has not registered with PECOS.

"We think a delay has to happen," said Walt Gorski, vice president of government affairs for AAHomecare. "CMS needs to do a better job of educating physicians on this issue. They just can't rely on HME providers. Physicians have no skin in the game. How about having their claims denied for not enrolling in the program? Why is it that the HME claims are the only ones subject to denial?"

AAHomecare has discussed PECOS with CMS officials, but so far "they are not ready to issue a delay," Gorski said.

That's too bad, said Marilyn Green. As the executive assistant for the Northeast Missouri Health Council in Kirksville, Mo., she's had plenty of first-hand experience using the PECOS registration system, and she agrees with the HME industry: It's a nightmare.

"I understand that this is a new system, but it should be simplified," said Green. "It's not clear. I've been logged out quite a few times and put on hold. And it is not allowing me to change some of the information I would like to change."

In all, Green has registered 11 physicians who work with the council's medical clinics. It's taken her about an hour per physician to scroll through and fill out PECOS's 52-page registration form.

"I hope I've done what I need to, but I think all of them are going to be wrong because I didn't know how to correct some of the information or was not able to correct it," she said.

HME provider Chris Rice has created a Web site,, that's intended to help educate physicians about PECOS and to help them register. The site is open to all HME providers. He's heard numerous complaints that echo Green's frustrations.

"There is no reason this should be this complicated," said Rice, the director of marketing for Diamond Respiratory Care, in Riverside, Calif. "It's ridiculous."

AAHomecare will continue to alert CMS of problems related to PECOS. The association also will talk with CMS early next month to check on the status of PECOS, Gorski said