Contingency Plan Set for NPI
The
Centers for Medicare & Medicaid Services (CMS)
announced that it is implementing a contingency plan
for covered entities (other than small health plans)
who will not meet the May 23, 2007, deadline for compliance
with the National Provider Identifier (NPI) regulations
under the Health Insurance Portability and Accountability
Act (HIPAA) of 1996. Details are contained in a CMS
document entitled, “Guidance on Compliance with
the HIPAA National Provider
Identifier (NPI) Rule.”
To view
this guidance, visit http://www.cms.hhs.gov/NationalProvIdentStand/Downloads/NPI_Contingency.pdf
on the CMS website. A press release on this topic
is also available at http://www.cms.hhs.gov/apps/media/press_releases.asp
on the web.
The
final rule establishing the NPI as the standard unique
health provider identifier for health care providers
was published in 2004 and requires all covered entities
to be in compliance with its provisions by May 23,
2007, except for small health plans, which must be
in compliance by May 23, 2008.
CMS
encourages health plans to assess the readiness of
their provider communities to determine the need to
implement contingency plans to maintain the flow of
payments while continuing to work toward compliance.
Likewise, we encourage health care providers that
have not yet obtained NPIs to do so immediately, and
to use their NPIs in HIPAA transactions as soon as
possible. Applying for an NPI is fast, easy and free.
Visit the National Plan/Provider Enumeration System
(NPPES) website at https://nppes.cms.hhs.gov/.
A
critical aspect of implementing the NPI is the ability
for covered entities to match a provider’s NPI
with the many legacy provider identifiers that have
been used to process administrative transactions.
CMS plans to make data available from the NPPES system
that will assist covered entities in developing these
“crosswalks.”
As
always, more information and education on the NPI
can be found at the CMS NPI page http://www.cms.hhs.gov/NationalProvIdentStand
on the CMS website.
Getting
an NPI is free - not having one can be costly.
