NCPA urges delay of PECOS changes that could deter community pharmacy industry

ALEXANDRIA, Va. Fearing that the implementation of an electronic provider enrollment program for Medicare Part B in its current form by the Centers for Medicare and Medicaid Services could disrupt Part B beneficiaries’ ability to obtain access to their services and supplies, the National Community Pharmacists Association is hoping that the CMS will delay its implementation and make other changes.

The provider enrollment, chain and ownership system is an online system that Part B providers can use instead of paper enrollment so that they can sell durable medical equipment, prosthetics, orthotics and supplies, also known as DMEPOS.

The CMS originally had planned to roll out PECOS on Tuesday, but it announced June 30 that while the original implementation date would still be effective, it would “not implement changes that would automatically reject claims based on orders, certifications, and referrals made by providers that have not yet had their applications approved by July 6, 2010.” The NCPA had asked the CMS to delay implementation until Jan. 3, 2011.

Other recommendations made by the NCPA included requiring pharmacy access to nightly provider-referrer enrollment updates to PECOS and removing requirements to include the teaching physician as the ordering or referring supplier and the legal name of the physician or eligible provider on the claim.

“Community pharmacies appreciate and support the PECOS program’s effort to reduce waste, fraud and abuse in Medicare,” NCPA acting EVP and CEO Douglas Hoey said. “However, the slow pace of enrollment and database updates, along with other deficiencies, creates headaches for community pharmacies and could limit access to Medicare Part B medical supplies for seniors, especially in underserved areas.”

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