FLORIDA MEDICAID EXTENDS ITS CONTINGENCY PLAN FOR NPI

The Centers for Medicare and Medicaid Services (CMS) recently issued a contingency plan extending the deadline for full compliance with the National Provider Identifier (NPI) Rule to May 23, 2008. The NPI rule requires all covered entities to use the NPI for Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated transactions. The contingency does not delay the effective date of the NPI rule, but allows covered entities to avoid possible citations if they can show they are making due diligence to becoming compliant. CMS allows each payer to decide their own contingency deadline.

Florida Medicaid is extending its contingency plan from July 1, 2007 to October 1, 2007. Providers will still be allowed to send in claims using the current Medicaid legacy numbers and claims will pay. However, we strongly urge providers to send in claims now with the NPI or NPI + taxonomy + zip they registered with Florida Medicaid. Testing now with the NPI solution will help ensure uninterrupted claims processing in October 2007.

What should you do?

Providers enrolling on or after May 8, 2007 (including new Medicaid ID suffixes to existing base numbers), must register using the paper registration form located on the fiscal agent website: http://floridamedicaid.acs-inc.com/index.jsp. Click Provider Support, then Enrollment. The NPI registration form is located in the area labeled “Enrollment Application and Related Documents”. The completed paper registration form should be mailed to the following address:

ACS State Health Care
Provider Enrollment
PO Box 7070
Tallahassee, FL 32314-7070.

All NPI-eligible providers should enter their NPI on electronic claims, but may also enter their Medicaid ID to insure proper processing.

Paper claims may contain either the NPI or Medicaid ID before and after the October 1, 2007 contingency deadline.

Companion Guides:
Companion guides for all HIPAA mandated transactions are available on the ACS website: http://floridamedicaid.acs-inc.com/index.jsp. Click HIPAA Information, then Companion Guides to find a listing of companion guides available for download.