The U.S. Centers for Medicare and Medicaid Services (CMS) will not implement changes that go into effect July 6 that would automatically reject claims submitted by physicians not yet included in the agency's Provider Enrollment, Chain, and Ownership System (PECOS), the agency said.
PECOS is the electronic system used to enroll physicians and eligible professionals into the Medicare program.
"CMS will, for the time being, not implement changes that would automatically reject claims based on orders, certifications, and referrals made by providers that have not yet had their applications approved by July 6, 2010," the agency said in a statement.
In February, CMS announced that it would delay PECOS requirements until January 3, 2011, but the passage of healthcare reform legislation in March mandated that these requirements go into effect on July 1. In May, CMS issued an interim final rule and invited a comment period for the regulation that closes on July 6 (60 days after the rule was issued), after which the comments will be reviewed and considered before a final regulation is issued.
"This [action] represents our best efforts to reconcile the statutory mandate with concerns of providers who are not yet in PECOS or whose enrollment information is not current, and who may have difficulty coming into compliance by the shortened deadline," said Ellen Griffith, CMS spokesperson.
Until the automatic rejections are operational, providers should not see any change in the processing of submitted claims. The claims will continue to be reviewed and paid as they have historically been reviewed and paid, CMS said.
"[CMS wants to] ensure that Medicare beneficiaries can continue to receive the healthcare services and items they need," the agency said.
Related Reading
CMS delays PECOS implementation until 2011, February 18, 2010
CMS cancels place-, date-of-service guidance, February 8, 2010
Editorial: CMS unfairly held VC to higher standard, February 5, 2010
CMS taps three for accreditation, January 29, 2010
CMS to deny claims submitted by unregistered PECOS physicians, January 6, 2010
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