More on the recent NPI Enforcement Guidance

Modern featured an in-depth article on the HHS enforcement guidance, reported in the FEHBlog yesterday, that permits the establishment of contingency plans for problems encountered in implementing the HIPAA National Provider Identifier. Those problems are cataloged in this Healthleaders’ article.

Of particular note in the Modern article is the report by Robert Tennant, senior policy adviser for health informatics at the Medical Group Management Association, and George Arges, senior director of the health data management group at the American Hospital Association of “rumors circulating that the CMS will soon issue a second advisory, with a different, possibly shorter extension for compliance with the NPI provisions for transactions with the Medicare program.” Unless CMS creates Medicare contingency plan, FEHB plans, which serve as secondary payer for hundreds of thousands of Medicare beneficiaries, will be faced with a significant claims and customer service problem when Medicare starts rejecting claims for missing NPIs.