CMS announces streamlined access to PECOS, EHR and NPPES

Diedra Gray
01/08/2014 at 3:00PM

The Centers for Medicare & Medicaid Services (CMS) announced that changes have been made to simplify the way providers access the Provider Enrollment Chain and Ownership System (PECOS), the Electronic Health Records (EHR) Incentive Program, and the National Plan and Provider Enumeration System (NPPES). These updates will improve the user experience when registering as an individual practitioner, authorized or delegated official of an organization, or when working within PECOS on behalf of a provider (also known as a surrogate).

The new process will:

  • Allow registered users to manage and reset their user ID and password online without calling a CMS Help Desk
  • Provide a simple and secure way for providers and suppliers to authorize individuals or groups of individuals to act on their behalf in PECOS and EHR
  • Allow designated, authorized officials already on file with Medicare to be quickly approved to access PECOS without the need to submit documentation to CMS for verification prior to submitting the application
  • Allow organizations with potentially large numbers of credentialing or support staff to manage staff access to the various functions
  • Increase security to reduce the risk of provider identity theft and unauthorized access to systems

It's also important to note that physicians who have a user ID and password from NPPES, or currently access PECOS, NPPES and/or EHR, will not see their accounts affected by these changes. Physicians will continue to utilize their established user ID and password to access the systems.

CMS also cautions users that, under the updated system, passwords in the Identify & Access Management System, which controls access to PECOS, NPPES and the EHR incentive programs, will expire every 60 days. If a password expires, it will not impact the NPI, Medicare enrollment, claims payments or EHR incentive payments will not be impacted, nor will the ability be removed for any surrogates to attest or work on behalf of their providers if they had previously been authorized in the system. It will only prevent logging in to those systems. Should a password expire, users will be prompted to reset it the next time they attempt to login to any of the systems.

CMS announces new data-sharing tool
The CMS on Nov. 12 announced the launch of their new Virtual Research Data Center (VRDC), an effort by the Obama administration to make the health-care system more transparent and accountable while helping to meet the major challenges of health-care delivery system reform. In an attempt to improve researchers' ability to extract knowledge and insights from large and complex collections of digital data, the VRDC offers a secure and efficient way for researchers to virtually access and analyze CMS's large volume of health-care data.

The CMS states that researchers will be able to access CMS data from anywhere and manipulate that data within the VRDC. This is drastically different from previous policies at the CMS, wherein researcher data requests came via prepared encrypted data files. The CMS believes this will not only reduce the strain on the agency to provide these data sets, it also will meet the growing demand in a more efficient and cost effective manner for the user.

The CMS estimates that the current process of providing large samples of Medicare Parts A, B and D data could cost a researcher more than $100,000 for one year of data. With the VRDC system in place, a single researcher conducting one project over the course of the year can access as much Medicare data as is needed for approximately $40,000.

Additionally, the CMS notes that with VRDC, researchers don't have to maintain expensive data infrastructures on their own. All data information will be accessed in a CMS environment utilizing a secure virtual desktop. And because researchers will be able to access data via the desktop, they will also be able to regularly refresh their data instead of the once annually data-delivery currently in place.

The VRDC system will also offer greater security for the CMS to protect individuals' information while still sharing data with researchers. Because sensitive, individually identifiable information about beneficiaries will remain within the CMS environment, that information is more easily safeguarded against breaches or unauthorized uses of the data.

For information on in utilizing the VRDC for research, go to

CMS offers payment adjustment tool for eHealth programs
The CMS has provided physicians with a simple, online tool to quickly determine whether they will receive a payment adjustment from a federal quality reporting program. Part of the CMS's eHealth Initiative, which is designed to help simplify the adoption of electronic standards and health-information technology, this tool is available for those physicians participating in the 2013 Electronic Prescriptions (eRx) program, Meaningful Use or the Physician Quality Reporting System (PQRS).

The online tool allows physicians to answer a few simple "Yes" or "No" questions to determine whether or not they will be subject to a payment adjustment. Physicians can download this free tool by going to the CMS website at