WASHINGTON — The Centers for Medicare and Medicaid Services will review national provider identifier protocols that now require separate numbers for each covered entity. The requirement could mean some physicians who are also part of group practices and other arrangements would have multiple NPI numbers.
Members of the Practicing Physicians Advisory Council brought the issue to the attention of CMS's director of program integrity, Kimberly Brandt. “The goal here was to have less numbers, not more. So I appreciate your point, and it's something I will definitely look into,” Ms. Brandt said.
NPI enrollment began May 2 and continues through May 2007, when all providers will be required to use the system for standard electronic health care transactions. “With national standards and identifiers in place for electronic claims and other transactions, health care providers will be able to submit transactions to any health plan in the United States,” CMS Administrator Mark McClellan, M.D., said in a letter to health care providers.
As a requirement of the Health Insurance Portability and Accountability Act, many health plans—including Medicare, Medicaid, private health insurance issuers, and health care clearinghouses—must use NPIs in standard transactions by May 2007. Small health plans have an additional year to comply. The number is intended to replace current numbers, including the unique physician identification number (UPIN).
To demonstrate the process of getting an NPI, PPAC Chairman Ronald Castellanos, M.D., got his number at the council's meeting, in a process that took approximately 8 minutes.
Ms. Brandt said that CMS is encouraging health plans to devise a transition plan for a system that accepts both the UPIN and NPI until the May 2007 compliance deadline. CMS is recommending that members of groups not sign up individually now but wait until fall, when “batch enumeration” systems will be in place to accept group applications.
Once assigned a random NPI, providers will have that number for the remainder of their careers and need only contact CMS to make changes.