NPI: CMS Announcements
May 2007
Update: FAQs About NPI Contingency Plans
The Centers for Medicaid & Medicare Services (CMS) Web site updated its Frequently Asked Questions (FAQs) about the National Provider Identifier (NPI) to assist Medi-Cal providers with compliance to NPI contingency plans. Some of the new FAQs include:
- What are the exact dates for the NPI contingency plan?
- If a complaint is filed against me for not being in compliance with the NPI after May 23, 2007, what will happen?
- What happens if a complaint for not being in compliance with the NPI is filed against me after May 23, 2008?
- Is it acceptable for a health plan to announce their NPI contingency now?
- Is the NPI contingency plan voluntary?
- Am I allowed to give my NPI to other providers as well as to the health plans with whom I exchange transactions?
Providers may review these FAQs and other NPI information on the NPI Frequently Asked Questions Web page. Click the downward arrow (▼) to the right of the “Date Updated” column heading to review these FAQs identified by the word "New" preceding the question.
Obtain Information on Contingency Plans
CMS encourages providers to review this information as well as
information from the health plans they bill so they are prepared
in case a specific health plan were to announce its own
contingency plan.
Reminder: Sharing NPIs
Providers must share their
NPIs with other providers with whom they do business and with
health plans that request their NPIs. As outlined in current
regulation, providers who are covered entities under HIPAA must
share their NPIs with any entity that requires an NPI for
billing. This includes providers who need an NPI for ordering
services or referring a physician. Providers should also
consider allowing health plans or institutions they work for
share their NPIs for them.
Reminder: Applying for an NPI Does Not Enroll Providers
Into Health Plans
Applying for an NPI and enrolling in a health plan are two
different functions. Having an NPI does not guarantee payment by
any health plan.
Still Confused?
Not sure what an NPI is and how you can get it, share it and
use it? More information about NPI can be found in the
NPI area of the CMS Web site. Providers may apply for an NPI
online at the
NPPES Web site, or they can call the NPI Enumerator to
request a paper application at 1-800-465-3203.
Getting an NPI is free – not having one can be costly.
May 2007
Frequently Asked Questions About NPI Contingency Plans
The Centers for Medicaid & Medicare Services (CMS) continually updates Frequently Asked Questions (FAQs) about the National Provider Identifier (NPI). Medi-Cal is providing a link to the CMS Web site which now features FAQs. This link is provided as an additional resource that may assist Medi-Cal providers with compliance to NPI contingency plans. This information is not specific to Medi-Cal. Some of the FAQs include:
- What will CMS be looking for in an acceptable NPI plan?
- Why is the contingency period limited at all?
- How does this guidance differ from the recommendations made to the Department of Health and Human Services (HHS) by the National Committee on Vital and Health Statistics (NCVHS)?
- I am a provider. What should I do now to determine how this guidance affects me?
- Does this mean that providers have an additional 12 months to obtain and begin using NPIs?
- Will Medicare have a contingency plan and what will it be?
- How will covered entities decide when to end their contingency plans?
- When should a covered entity announce its NPI contingency plan?
Providers may review these FAQs and other NPI information on the NPI Frequently Asked Questions Web page. Click the downward arrow (6) to the right of the “Date Updated” column heading to see the most recent updates to the FAQs.
Not sure what an NPI is or how you can get it, share it
and use it?
More information about NPI can be found in the
NPI area of the CMS Web site. Providers may apply for an
NPI online at the
NPPES Web site, or they can call the NPI Enumerator to
request a paper application at 1-800-465-3203.
Getting an NPI is free – not having one can be costly.