CMS has added an MLN Matters article about the PECOS delay which was announced earlier this week. It is titled: SE1305 – Full Implementation of Edits on the Ordering/Referring Providers in Medicare Part B, DME, and Part A Home Health Agency (HHA) Claims (Change Requests 6417, 6421, 6696, and 6856).
NAHC has posed the following questions to CMS:
- Must home health agencies issue a beneficiary notice to patients whose services will be terminated because of failure of their physician to be enrolled in PECOS and, if so, what notice?
- May home health agencies hold beneficiaries liable for the cost of care?
- Do apostrophes appear in PECOS files and in the edit files that will be used by the MACs (conflicting guidance from CMS to providers about use of apostrophes)
- Will claims be edited against the original Phase 2 May 1, 2013 “from” date or will this date be amended?
- Would CMS please add the effective date of physician enrollment to the Ordering/Referring File?
The Alliance appreciates NAHC pushing for these answers and will share information as we get it.
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