CMS Delays Implementation of PECOS Enrollment Policy

The Centers for Medicare & Medicaid Services (CMS) will delay implementation of the second phase of modifications to the Provider Enrollment, Chain, and Ownership System (PECOS) regarding ordering/referring providers from April 5, 2010 until Jan. 3, 2011.  Providers who enrolled in Medicare prior to 2003 but have not completed the revalidation process are not included in the PECOS system. CMS had plans to reject claims associated with these providers starting April 5, 2010.   CMS’ plans have been revised to include the following activity pior to the new Jan. 3, 2011 deadline:

• Continue to place warnings on claims in which the ordering/referring is not enrolled in PECOS;

• Update the Medicare Ordering/Referring File;

• Remind providers who enrolled in Medicare prior to 2003 but have not completed the revalidation process to submit a new enrollment application either in the paper form or by using Internet-based PECOS.