November 2006

Information on Covered Entities Under HIPAA
The CMS Web site has posted new information that addresses whether a health care provider is a covered entity under HIPAA if they receive health information electronically (e.g., an electronic remittance advice), but do not transmit any health information electronically. Refer to Frequently Asked Question (FAQ) # 7906 on the CMS Web site.

Clarification of the NPI Taxonomy Requirement Outlined in CR5243
Effective January 1, 2007, institutional providers who submit claims to Medicare for their primary facility and its subparts (such as psychiatric unit, rehabilitation unit, etc.) must report taxonomy codes on all claims submitted to their Fiscal Intermediary. Refer to FAQ # 7896 on the CMS Web site.

Reminder to Supply Legacy Identifiers on NPI Application
CMS continues to urge providers to include legacy identifiers on their NPI applications. This will help all health plans, including Medicare, to get ready for May 23, 2007. HIPAA mandates the use of NPIs by that day. If reporting a Medicaid legacy number, include the associated state name. If providers have already applied for their NPI and did not include their legacy identifiers, CMS is asking them to go back to the NPPES Web site to update their information. The legacy identifiers are critical for health plans and health care clearinghouses in the development of crosswalks to aid in the transition to the NPI.

New WEDI "Early Adopters" Series
The Workgroup for Electronic Data Interchange (WEDI) has developed a series of monthly 90-minute audio casts that highlight NPI planning, management, communication and implementation activities. The first "Early Adopters" audio cast occurred on October 4, 2006, and is available for purchase on audio CD. Visit the WEDI Web site for more information and to register for future events.