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PECOS edits, PPS rebasing cuts proceed.

In a matter of days, it’ll be time to pay the piper if your referring physicians haven’t enrolled in PECOS as they should have.

Ordering/referring edits, or so-called PE-COS edits, will take effect Jan. 6 as planned, HHH Medicare Administrative Contractor CGS notes in its December newsletter for home health providers. "Billing transactions and adjustments for home health services with the ‘FROM’ date of service on or after January 6, 2014, will be denied if the atten-ding physician National Provider Identifier (NPI) and name do not exactly match the NPI and name that is on the Provider Enrollment, Chain and Own-ership System (PECOS) file," the MAC stresses.

Don’t forget: The edits will compare the first four letters of the last name, CGS reminds home health agencies. Include the first and last name as it appears on the ordering and referring file at . "Middle names (initials) and suffixes (such as MD, RPNA, etc.) should not be listed in the ordering/referring fields," the MAC instructs.

Meanwhile: The punishing 3.5 percent re-basing cut is proceeding as finalized in the 2014 Home Health Prospective Payment System final rule (see Eli’s HCW, Vol. XXII, No. 42). See CMS’s official transmittal containing the new rates at and its group-er for the update at .

Getting a repeal of home health rebasing was a near miss in congressional budget negotiations for 2014, reported the National Association for Home Care & Hospice in a call on the issue. But "the home care and hospice community is well-positioned to see either a rollback or repeal of the detrimental rule in the early part of the New Year," the trade group believes. The move will require a major grassroots effort from the industry, however, NAHC cautions.

At least Congress’ budget legislation didn’t include harmful provisions such as home health copayments, observers note.