In August 2010, the Association of American Physicians and Surgeons (“AAPS”) filed an amended complaint asking the court to vacate HHS regulations requiring non-Medicare providers to enroll with Medicare, to appear in the Provider Enrollment, Chain and Ownership System (“PECOS”), or to obtain a National Provider Identifier (“NPI”). A copy of AAPS’ full amended complaint is available here.
AAPS argues that the ability of non-Medicare enrolled physicians to order or refer for services provided by enrolled entities enables Medicare beneficiaries to pay directly for services provided by a non-enrolled physician of their choice without renouncind all their Medicare entitlement. Eliminating the ability to refer for Medicare items and services would increase the costs associated with obtaining services from non-Medicare physicians put those physicians at an economic and competitive disadvantage vis-à-vis Medicare providers. Furhter, enrolling or registering in Medicare or PECOS and obtaining an NPI require upfront and ongoing paperwork and monitoring on the part of physicians who do not wish to participate in Medicare.
More information on the AAPS suit is available on the APPS website.