Physician Regulatory Issues Team (PRIT)
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Content Section
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Details for CR 6421, Orders for Medicare Services by Physicians Not Enrolled in PECOS
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Shown below are the details for the item you selected from the list.
| Issue Name |
CR 6421, Orders for Medicare Services by Physicians Not Enrolled in PECOS |
| Issue |
Change Request 6421 announces a new policy concerning ordering referring physicians and Medicare billed services. This policy will deny payment for any services ordered by a physician who is not enrolled in PECOS after January 4, 2010. Although this policy would help protect the Medicare program from fraudulent and erroneous charges it would prove challenging for training programs because many if not most residents are not enrolled in PECOS and interns can not enroll because they are not licensed. Many DOD physicians and VA physicans are also not Medicare enrolled. |
| Status |
See below. |
| Date Issue Created |
09/28/2009 |
September 28: AAMC recently discussed these issues with CMS enrollment staff and were assured that CMS will continue dialogue with representatives of the health care provider community as to whether CR 6417 should be fully implemented beginning January 4, 2010.
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Last Modified Date : 10/01/2009
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