The CMS is in the early stages of seeking a new vendor to revamp its widely disliked Medicare provider enrollment system and hopes to expand it to Medicaid.
The CMS launched the system (formally called the Medicare Provider Enrollment Chain and Ownership System, or PECOS) in 2008 as an alternative to the paper Medicare enrollment process. The system allows physicians, non-physician practitioners, and provider and supplier organizations to enroll, make changes to their Medicare enrollment, view their Medicare enrollment information on file with Medicare, or check on the status of a Medicare enrollment application via the Internet.
For years providers have criticized the system for accuracy problems. The need for information in the system to be accurate is especially critical since it is used to populate Medicare's Physician Compare website, which is intended to help consumers find and choose high quality providers.
A 2013 HHS Office of Inspector General Report found that 58% of records on PECOS contained inaccurate data and almost 4% were incomplete. The American College of Surgeons said in a letter to CMS last month that many of its members "find PECOS to be very problematic and dysfunctional.”
The CMS is now in the early stages of searching for a new vendor for the site and has now released a "sources sought" notice to determine whether companies have the technical capabilities to redesign the system. Such notices precede a formal request for bids for work.
In 2011, CGI Federal won a five-year $55 million contract from the CMS to provide software development and operational support services for PECOS.
The agency described the PECOS revamp as a ground-up redesign and said it hopes the new system, referred to as PECOS 2.0, will not only make it easier to enroll in Medicare, but also to be used for the first time for providers enrolling in Medicaid.
Medicaid currently has no national enrollment database for providers. Instead, they enter into a provider agreement with the states directly.
“PECOS 2.0 … is focused at transitioning the system from a single purpose product to an enterprise resource that is a platform for all enrollments across Medicare, Medicaid and emerging provider programs,” the CMS said in the notice.
No timeline was revealed in which Medicaid providers may have to begin to enroll in PECOS. The CMS is giving interested vendors until Dec. 22 to respond to the notice about their technical capabilities.
The move to have Medicaid providers also use PECOS could be concerning to the medical community, who have long complained about the system.
“We continually hear from physicians whose PECOS listings do not reflect the information they have entered into the system,” the American Medical Association said last year in a letter sent to CMS.
And the American Academy of Family Physicians said in a letter sent this year that using PECOS is “notoriously cumbersome, time-consuming and challenging process for providers and physicians."
