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PECOS  

CMS announced a delay in implementation of Phase II of the PECOS - Provider Enrollment, Chain and Ownership System until April 5, 2010, to give physicians and non-physician practitioners more time to update their Medicare Enrollment Record.

 

If a physician, or non-physician practitioner refers a patient to another provider for services and/or items, but failed to update their Medicare Enrollment Record by April 5th, the Supplier/Providers claim(s) are supposed to be denied.

 

My opinion is the PECOS is just another way of "linking" pieces together to help combat Fraud & Abuse, and enforcing stronger accountability. 

 

I personally agree 100% with stengthening Fraud & Abuse efforts; however, I believe we need a better system set in place on the front end, and more manpower to accomodate the changes they continue to make.  Although the CMS and the NSC have taken great strides with tackling revisions to the DMEPOS Supplier Enrollment Application, and mandating Facility Accreditation for some, it has caused a huge backlog in the Supplier/Provider Enrollment process. With the delay in the PECOS implementation date of April 5, 2010, I can't help but chuckle, because I can only forecast another delay because of the backlog already established.

 

Without writing a book, I will close in saying, we need better infrastructure! I'm not confident with the way the system operates today, nor am I confident in those in charge of operations.  In addition, I doubt very seriously that "Healthcare Reform" would bring positive changes to our healthcare system, especially with the mess that has already been created.  Who created this big mess anyway??? 

 



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