Does' NPIs to be available on the Internet.
You finally have a date that you can expect a National Provider Identifier directory for referring physicians' NPIs.
The Centers for Medicare & Medicaid Services will issue the NPI information June 28 as drawn from National Plan and Provider Enumeration System (NPPES) data.
"Anyone may request NPIs and other NPPES health care provider data from [the Department of Health and Human Services]," HHS says in a May 30 Federal Register notice. "HHS will make NPPES health care provider data available on the Internet."
HHS won't release sensitive information such as physicians' social security numbers, tax numbers and dates of birth. But other NPPES data will be in the directory. "We believe that making these data available on the Internet is the most efficient and effective means of dissemination," HHS says.
More information is online at
www.cms.hhs.gov/NationalProvIdentStand.
Compliance risk: And if you don't have your NPI now that the May 23 deadline has passed, you are courting trouble. "At this point, any covered entity that is noncompliant, and has not implemented a contingency plan, is at risk for enforcement action," CMS warns in a message to providers.
CMS' contingency plan guidance "does not mean that providers have an extra year to get an NPI," CMS cautions. Under CMS' plan, providers should be using their own NPIs but can still use the previous "legacy" billing numbers for referring physicians (see Eli's HCW, Vol. XVI, No. 18).
Try this: "Medicare is now asking that submitters send a small number of claims using only the NPI," CMS instructs providers. "If no claims are rejected, the submitter can gradually increase the volume." • Congress may be looking to raise budget funds by cutting payments to Medicare managed care plans, but home care providers' Medicare payment rates are still at risk.
House Ways & Means Health Subcommittee Chair Pete Stark (D-CA) said in a May 15 hearing that he's considering across-the-board cuts for Medicare providers (see Eli's HCW, Vol. XVI, No. 19).
But in a May 17 hearing and release about Medicare Advantage private fee for service (PFFS) plans, Stark made clear that Medicare PFFS plans are a good place to start making cuts. Medicare pays these plans on average 119 percent of fee-for-service rates. And plan enrollment is skyrocketing because salespeople tell seniors they get extra benefits for receiving the same services as under regular FFS Medicare.
However, the plans tend to charge higher cost-sharing amounts for services such as home care, Stark noted. "My guess is that this is NOT coincidental," he says in a release. "If you don't want sick people, you charge more for the services that they are looking for."
"PFFS plans appear to provide far better value to their shareholders [...]
