Updated 7/06/2010

Medicare PECOS July 6 Deadline Postponed

The Centers for Medicare & Medicaid Services (CMS) recently announced it is working with providers to address concerns about the July 6, 2010 deadline for enrollment in the Provider Enrollment, Chain and Ownership System (PECOS) database. PECOS is the electronic system used to enroll physicians and eligible professionals into the Medicare program.

CMS’ decision is largely in response to strong opposition from the Heart Rhythm Society and the broader medical community, which has been very engaged with CMS since the deadline was established in an interim final regulation published on May 5, 2010. That regulation called for all physicians and other health care providers who make referrals or orders to other physicians/providers to be enrolled (or update their enrollment application if enrolled prior to 2003) in the PECOS database by the July 6 deadline.

While the regulation will be effective July 6, physicians that list the name and NPI of a referring / ordering physician who is not yet enrolled in PECOS will not receive claim denials beginning on this date. For the time being, claims will continue to be reviewed and paid as they have historically been.

CMS is continuing to update and streamline the enrollment process and has confirmed that it will not implement changes that would automatically reject claims until further notice.

CMS will continue to send informational notices to providers reminding them of the need to submit or update their enrollment information and will work with the provider community to provide guidance on enrollment and process all applications expeditiously.

Please visit the below websites more information on:

• Medicare contractor phone numbers
• CMS Medicare enrollment website

Original posting 6/18/2010

PECOS Enrollment Deadline Moved Up to July 6, 2010

CMS recently announced that the deadline for referring or ordering physicians to enroll in the Provider Enrollment Chain and Ownership System (PECOS) will be moved up to July 6, 2010. This announcement was made in an Interim Final Rule (IFR) Medicare and Medicaid Programs; Changes in Provider and Supplier Enrollment, Ordering and Referring and Documentation Requirements; and Changes in Provider Agreements [CMS-600-IFC].

Earlier this year, CMS had extended the enrollment deadline to January 1, 2011 to allow physicians to enroll or update their Medicare status in PECOS. With the passage of the Patient Protection and Affordable Care Act, that deadline was moved up to July 6, 2010.

The Heart Rhythm Society joined many prominent members* of the cardiovascular medical community in expressing significant concerns not just with the July deadline, but with the scope of the new enrollment requirements, definition of referral, deactivation of billing privileges, documentation requirements, specialist services and access to documentation. Read the letter (PDF, 600K) sent to CMS Acting Administrator Marilyn Tavenner.

If you enrolled in Medicare after November 2003, or if you enrolled before November 2003 and have updated your Medicare enrollment information since November 2003, no further action is required on your part. Information on how to establish an enrollment record in PECOS can be found on the CMS website.

If you are unsure of your enrollment record in PECOS, there are several ways to verify your status:

1. Check the Ordering Referring Report on the CMS website.
   If you are on that report, you have a current enrollment record in PECOS. Go to www.cms.gov/MedicareProviderSupEnroll, click on "Ordering Referring Report" on the left.
2. Use Internet-based PECOS to look for your PECOS enrollment record.
   (You will need to first set up your access to Internet-based PECOS.) If no record is displayed, you do not have an enrollment record in PECOS. Go to www.cms.gov/MedicareProviderSupEnroll , click on "Internet-based PECOS" on the left, for information on using Internet-based PECOS.
3. Contact your designated Medicare enrollment contractor and ask if you have an enrollment record in PECOS.
   Go to www.cms.gov/MedicareProviderSupEnroll , click on "Medicare Fee-For-Service Contact Information" under "Downloads."

* Joining the Heart Rhythm Society as signatories were the presidents of the American College of Cardiology, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society for Cardiovascular Magnetic Resonance, American Society of Echocardiography, Heart Failure Society of America, Society for Atherosclerosis Imaging and Prevention and the Society for Cardiovascular Computed Tomography