National provider identifier deadline extended

Healthcare managers both in and outside of IT got a reprieve last week when CMS agreed to postpone the deadline by which all providers must get and use a national provider identifier number. Hospitals have largely gotten their NPIs, but physicians have not all gotten on board, which has slowed things down considerably, said George Arges, senior director of the health data management group at the American Hospital Association. The AHA had put in a request to CMS explaining the problem and requesting the extension. The government has also slowed things down by failing to set up a good system for sharing a national database of NPIs for use among healthcare trading partners. Without this data, providers can't check to make sure that their partners' numbers are correct, a failing which prevented most NPI implementations from getting off the ground.

Providers now have up to one year from the existing May 23rd deadline before CMS will start slapping them with penalties and other enforcement actions. The terms are a bit ugly, however. To stay out of dutch--and keep getting paid--providers must file a complaint against other trading partners that aren't on board, then set up a "contingency plan" to keep working toward compliance. In the mean time, steps that would make CMS happy include testing NPI-based transactions with outside partners, even if you're not ready to implement NPIs as a substitute for your countless legacy identifiers. Providers and health plans will get help in cross-referencing all of those identifiers from CMS's National Plan and Provider Enumeration System.

To get more details on the NPI enforcement delay:
- read the CMS press release
- read this Modern Healthcare piece

ALSO: Here's how one hospital is coping with the looming NPI issue. Blog

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