CMS instituted the Internet-based Provider Enrollment, Chain and Ownership System (PECOS) as an alternative to the paper enrollment process. This system allows healthcare practitioners and supplier organizations to enroll, make changes, view and check statues of their Medicare enrollment information via the internet. Phase 1 began in October 2009 to alert billing providers that they must have a valid identification number of the ordering/referring provider. Phase 2 is set to take effect in January 6, 2014 where all ordering/referring providers must have an identification number for all claims or the claim will be denied. Physician enrollment has been a requirement for home health and DME. Now it will be enforced with penalties or denial of claims, if a physician is not enrolled after January 6, 2014. Failure to verify physician enrollment in PECOS will result in the entire claim being denied.