PECOS REJECTIONS DELAYED

CMS has just announced a new implementation date for PECOS rejections of January 3, 2011. CMS announced this delay yesterday. Prior to this announcement CMS maintained that implementation of rejections would begin to occur on April 4, 2010 for any services ordered by physicians who are not in PECOS. Suppliers will continue to get warnings on their remittance notices when your referring physician is not in PECOS, but claim rejections will not happen until next year. At some point during 2010, CMS will send letters directly to any physician not in PECOS, telling them that they must reenroll or they will not be able to make referrals. CMS staff also has indicated that the PECOS system will become available for DMEPOS supplier enrollment some time in 2010. We will notify you of any new information as it is announced.

Medicare 2010 Claim Alert

CMS has issued a notice stating that claims submitted between January 1, 2010, and January 15, 2010, for 2010 dates of service will be held pending final review of the Medicare Physician Fee Schedule (MPFS). CMS will release claims for payment on January 19, 2010.

Claims for dates of service on or before December 31, 2009, will be processed and paid under normal procedures.

PECOS REQUIREMENT

CMS' January 4, 2010 deadline requiring physicians to be registered with PECOS in order to write a valid prescription. No registration would result in no reimbursement to the O and P facility providing services under the unregistered physician's prescription. CMS agreed to delay implementaion until April 1, 2010 and promised that the PECOS physician regisrty will be on line before the program goes into effect.
The effective date was postponed to provide time to educate physicians and facilities the requirements.