Endocrine Insider
July 1, 2010

(See full issue)

The Centers for Medicare and Medicaid Services (CMS) announced that it will not automatically deny Medicare claims filed by physicians who fail to meet a July 6, 2010 deadline to enroll in the Provider Enrollment, Chain, and Ownership System (PECOS). Last, CMS released an interim final rule mandating that all physicians who order or refer imaging, laboratory, and specialist services must be enrolled in Medicare with their enrollment information in PECOS by July 6¸ 2010.  The enrollment date for these physicians was unexpectedly moved up from January 3, 2011.

While the regulation will be effective July 6, 2010, CMS will not immediately implement automatic rejections of claims submitted by providers that have attempted to enroll in PECOS.  Until the automatic rejections are operational, providers should not see any change in the processing of submitted claims, which will continue to be reviewed and paid as they have historically been reviewed and paid.

The Endocrine Society, the American Medical Association, and other medical specialty societies will continue to work together on this issue and press CMS to delay the implementation until 2011.