ALEXANDRIA, Va. Two groups representing the nation's pharmacies are urging doctors to enroll or update their records in the Centers for Medicare and Medicaid Services' Medicare provider enrollment, chain and ownership system.
In a fax sent to more than 62,000 doctors' offices, the National Association of Chain Drug Stores and the National Community Pharmacists Association said that by enrolling or updating their enrollment in PECOS can guarantee Medicare beneficiaries will be able to receive diabetes testing supplies and other essential durable medical equipment, prosthetics, orthotics and supplies from local pharmacies. According to CMS, there are 26,000 pending PECOS enrollment applications for physicians and a few thousand more for nonphysician providers.
“Community pharmacists support appropriate efforts to ensure that Medicare dollars are spent wisely, but beneficiaries’ access to local pharmacies for their legitimate healthcare needs must be protected,” said NACDS president and CEO Steve Anderson, and Douglas Hoey, NCPA acting EVP and CEO. “We commend CMS for striking the right balance by not implementing changes that would automatically reject claims based on orders, certifications, and referrals made by providers who have not had their applications approved by July 6. Community pharmacists report that as many as 30% of DMEPOS claims are being rejected. That’s a clear warning sign supporting CMS’ delay of the July 6 PECOS date. We urge all doctors to enroll or update their record in PECOS now to ensure their patients can continue to have uninterrupted access to essential medical products at their local pharmacies.”
Starting July 6, federal regulations require that providers who order or refer durable medical equipment and supplies be enrolled in PECOS for reimbursement claims to be processed, the groups said. On June 30, CMS announced that the agency will not implement automatic rejections of claims based on providers who have not had their PECOS enrollment approved by July 6.