CMS tells HME News: We expect providers to begin submitting PECOS compliant claims by July 6, 2010

Over the past week, we've written two stories on PECOS and a blog, and while I hate to beat a dead horse, this PECOS stuff is important. I also believe there is some misinformation circulating around out there as to whether or not HME providers should begin filing PECOS compliant claims by July 6, 2010. On Wednesday, HME News Managing Editor Theresa Flaherty emailed the following questions to Pete Ashkenaz, CMS's deputy director of media affairs.

Hi Pete: Sorry to keep bothering you, but we are are hearing now from other industry sources that CMS does not plan to reject claims until Jan. 2011 and that (PECOS) won't take effect until the final rule is published. Is there a way to get answers to any of these questions in layman's terms?

HME News: Does CMS expect DME providers to submit PECOS compliant claims on and after July 6?
CMS: Yes

HME News: What if providers submit non-compliant claims on or after July 6?
CMS: They will be in violation of the rules.

HME New: When does CMS expect to have the edit in place that will detect non-compliant PECOS claims?
CMS: That has not been finalized, (and will be) based on comments we receive on the (interim final rule).

HME News: Once this edit is in place, will CMS review claims retroactively?
CMS: That has not been finalized, (and will be) based on comments we receive on the (interim final rule).

HME News: Is it true that the interim final rule carries no weight? That is, until the final rule is in place, providers don't have to worry about submitting PECOS compliant claims?
CMS: An interim final rule is a final rule that is being enforced. The fact that the regulation is still open for comment means that we are encouraging comment on the rule that is already being enforced and may be tweaked based on public input.

You may not like it, but there it is, straight from the horse's mouth: CMS expects HME providers to begin submitting PECOS compliant claims by July 6.

Here are the links to the other articles we've written over the past week on PECOS:

PECOS update

CMS to Providers: No PECOS grace period

CMS's behavior on PECOS has been disgraceful

Mike Moran