CMS Fudges on PECOS Enrollment Deadline

Agency Says It Will Not Enforce July 6 Cutoff

July 02, 2010 05:00 pm News Staff

CMS has had a change of heart regarding its July 6 deadline for physician enrollment in the agency's Provider Enrollment, Chain and Ownership System, or PECOS.

According to a June 30 news release(, the federal regulation that requires all ordering and referring physicians to be enrolled in PECOS will still be effective as of July 6, but "CMS will, for the time being, not implement changes that will automatically reject claims based on orders, certifications and referrals made by providers that have not yet had their applications approved by July 6."

The decision to ease up on enforcing the deadline was made as CMS continues to receive feedback and complaints from physicians about PECOS' painful enrollment process.

"While more than 800,000 physicians and other health care professionals have successfully enrolled in PECOS, some Medicare providers have encountered problems," said CMS in the release. "CMS is continuing to update and streamline the process, and more providers have been enrolled in the past few days.

"Many physicians and other providers and suppliers have continued to make good faith efforts to comply with the requirements of the law and regulation," acknowledged CMS.

Just days ago, CMS announced that physician claims for items ordered or services rendered for Medicare beneficiaries would be automatically rejected if the ordering physician or other provider was not officially registered in the PECOS system by the July 6 deadline.

On May 5, CMS issued an interim final regulation implementing provisions of the Patient Protection and Affordable Care Act that, beginning July 1, permit only Medicare-enrolled physicians or eligible professionals to certify or order certain items and services under Medicare Part B. CMS is accepting comments on the proposed regulation through July 6 and will issue a final regulation after those comments are reviewed and considered.