CMS Launching PECOS 2.0 in Summer 2023

The Centers for Medicare & Medicaid Services (CMS) recently announced that it is planning to launch a new iteration of PECOS in Summer 2023. Dubbed “PECOS 2.0”, the new provider system aims to make the Medicare enrollment and revalidation processes faster and more efficient.

According to CMS, PECOS 2.0 will modernize Medicare enrollment management and allow providers to accomplish more tasks electronically. Some of these changes include faster applications using pre-population information, one application to update multiple enrollments, faster and easier revalidation processes, and the ability to track application status in real-time. CMS has also stated that provider data and records in current PECOS will transfer to PECOS 2.0 seamlessly. Applications currently in progress can be continued in PECOS 2.0, and applications previously closed will be available but will include limited information. All records transferred from current PECOS to PECOS 2.0 will be noted as such to make them easily identifiable. Additionally, providers’ login credentials will not be affected, and providers will still be able to log in to PECOS 2.0 using their Identity & Access (I&A) username and password.

With PECOS 2.0, providers will gain the benefit of consolidated applications, which is a combined application that updates and handles multiple enrollments. Consolidated applications will make it easier for providers to submit changes across multiple similar enrollments and multiple Medicare Administrative Contractors (MACs). When a provider submits a consolidated application that would normally require sending information to two different MACs, PECOS 2.0 will automatically separate the application and send the appropriate information to the relevant MACs. To ensure compliance with varying state requirements, PECOS 2.0 is also introducing a smart error process check which reviews and validates information for correctness as applications are completed. Moreover, there is no additional fee for consolidated applications. Whether providers choose to submit a consolidated application that covers multiple enrollments or an individual application for each enrollment, the fees will be the same and application fees will be automatically determined by each application.

Finally, with PECOS 2.0, providers will have a national profile that stores information Medicare has on file for their enrollments. Specifically, providers will be able to view identifying information (e.g., legal name and national provider identifier), associations (e.g., authorized officials, owners, directors, etc.), documents submitted in applications, and any correspondence with the MACs. The national profile is automatically updated when applications are approved.

Providers should be on the lookout for the official rollout of PECOS 2.0 in Summer 2023. However, providers should be cautious and monitor their information that is migrated to PECOS 2.0. CMS and the Medicare contractors send important information to correspondence addresses maintained in PECOS and hold providers responsible for incorrect information in PECOS. Data that CMS incorrectly migrates to PECOS 2.0 may lead to providers not receiving important correspondence, missing regulatory or appeal deadlines, or otherwise being held responsible for incorrect data in PECOS 2.0

For over 35 years, Wachler & Associates has represented healthcare providers and suppliers nationwide in a variety of health law matters, and our attorneys can assist providers and suppliers in understanding new developments in healthcare law and regulation. If you or your healthcare entity has any questions pertaining to Medicare enrollment or healthcare compliance, please contact an experienced healthcare attorney at 248-544-0888 or wapc@wachler.com.