The first of two crucial NPI deadlines hit March 1.
If you've been slow to implement National Provider Identifiers, you no longer have a choice.
As of March 1, the Centers for Medicare & Medicaid Services requires providers to submit an NPI in the primary provider field. Home health agencies, hospices, suppliers and other providers can submit an NPI-Medicare legacy number pair or can submit the NPI alone.
"Failure to include an NPI will cause the claim to reject," CMS warns in a message to providers.
Pitfall: Claims will also reject if the system can't find the NPI and legacy number pair on the NPI Medicare Crosswalk, CMS explains. In that case, you'll have to verify that your National Plan and Provider Enumeration System (NPPES) information is correct.
While one NPI deadline is down, there's still one to go. On May 23, CMS will require providers to cease submitting legacy numbers and instead submit only the NPI in the primary claim fields.
To get ready, providers should start submitting a small number of NPI-only claims now, CMS advises in the message. "If the claim is processed and you are paid, continue to increase the volume of claims sent with only your NPI," the agency says. "If the claims reject, go into your NPPES record and validate that the information you are sending on the claim is the same information in NPPES."
More NPI information is at
www.cms.hhs.gov/NationalProvIdentStand. • Last year's Home Health Quality Improvement (HHQI) National Campaign has wrapped up, and so has the continuing education for home health agencies that was part of the campaign, CMS points out.
The HHQI Organization Support Center has published its final package of best practice intervention tools, CMS notes. "All continuing education will end on February 28," CMS says.
Providers can still access the best practice tools and free continuing education units at
www.homehealthquality.org and
www.medqic.org, CMS adds.
The QIOs won't have a home health focus in their next contract, although some may choose to work with home care providers (see Eli's HCW, Vol. XVII, No. 9). • Assuring quality of care for government program beneficiaries is a high priority for the HHS Office of Inspector General, the OIG notes in a recent report outlining its management challenges. HHAs, hospices and suppliers will see resulting scrutiny.
The OIG is investigating the "cyclical noncompliance of home health agencies with conditions of participation," the watchdog agency says. It also aims "to determine the nature and extent of hospice services provided to beneficiaries residing in nursing homes."
But the OIG saves the full force of its wrath for the DME industry, which it portrays as a hotbed of fraud. The OIG has "consistently found that the Medicare durable medical equipment, prosthetics, orthotics, and [...]
