FW: CMS CLARIFIES GUIDELINES FOR NATIONAL PROVIDER IDENTIFIER (NPI) DEADLINE IMPLEMENTATION

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Sent: Tuesday, April 03, 2007 9:25

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Subject: CMS CLARIFIES GUIDELINES

FOR NATIONAL PROVIDER IDENTIFIER (NPI) DEADLINE IMPLEMENTATION

NPI: Get It. Share It. Use It.

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.

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.”

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.

As always, more information and education on the NPI

can be found at the CMS NPI page www.cms.hhs.gov/NationalProvIdentStand

on the CMS website.

Getting an NPI is free - not

having one can be costly.

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