[Cuda]

I'm curious about how all of you are handling your capped rentals under PECOS. I spoke to all 4 DME MACs today and they have no advice except to say all claims must be PECOS compliant by 07/06/10. Are you making a list, informing the patients and picking up your equipment for non enrolled ordering physicians? I know this would be an incredible hardship on patients but I'd like to see that happen nation wide, then maybe someone would get the message! I also spoke to several accreditation agencies who told me they were not in the loop regarding PECOS and if they had been they would have brought up patient access and care conerns to CMS regarding implenting PECOS compliant claims at this time.

[Regina]

Good point about the accreditation agencies. I have no idea what we will be doing about capped rentals yet.

[Cuda]

The way I see it, CMS has abused their authority and found a way to get out of paying for potentially months of capped rentals. Best case scenario you will lose 2-3 months if you place the equipment in July and the physician enrolls immediately. Worst case scenario you could lose 12 months of rentals if you placed the equipment in June and the physician never bothers to enroll. The PECOS mess is a perfect setup for CMS to put suppliers out of business. If a supplier does not pay attention and continues to bill non-compliant claims they will be paid until the edits are in place. Any paid claims will then be recouped and CMS has used the vailed threat of filing charges against the supplier via the False Claims Act. The only choice a supplier has is to not get paid for equipment they have out there. This is a much more serious problem than most suppliers realize.