Medicare FFS Update
Medicare FFS has made excellent progress over the past week, since fully implementing the NPI. In fact, the favorable trend in NPI compliance is better than we expected with most of the Medicare contractors reporting that over 90 percent of claims are NPI-compliant, with some reporting 100 percent compliance. Furthermore, we have experienced relatively few problems to date and we are working daily with our contractors to help resolve those issues that exist.
We would like to point out that, on May 23, there were a number of rejections for claims with legacy numbers in the SECONDARY provider identifier field. As indicated, we are seeing this particular issue rapidly improve as more and more providers realize the need for NPI-only in secondary identifier fields and the relative ease in which they can appropriately complete these fields.
In the way of background, Medicare allowed legacy-only numbers in the secondary fields up until May 23. To assist those billing providers which, after reasonable effort, are still unable to obtain NPIs for secondary providers, Medicare has instituted a temporary measure that allows billing providers to use their own NPI in secondary identifier fields. Thus, providers are not unduly burdened to ensure secondary identifier fields have an NPI.
While CMS is seeing some issues in some areas of the country, we are continuing to monitor and assist providers in becoming fully NPI-compliant. Progress has been substantial in recent days and weeks and this favorable trend is expected to continue. We would also like to mention that we monitor Medicare Part C (Medicare Advantage) and Part D (Prescription Drug Program) and we have received no reports of NPI problems.
Medicare Reminder--Accelerated/Advance Payments May Be Available for Financial Hardships Associated with NPI Implementation
Some Medicare providers, physicians, other practitioners, and suppliers might experience cash flow issues during their efforts to implement the NPI. The Medicare contractors and the Centers for Medicare & Medicaid Services (CMS) will consider, in limited circumstances, the availability of advance or accelerated payments where facts and circumstances fall within the scope of the CMS regulations and/or manual requirements for such payments.
In general, entities who bill without an NPI do not warrant consideration for an advance or accelerated payment since Medicare providers have been given ample time to secure an NPI.
Medicare providers who may be experiencing cash flow problems related to NPI claims processing issues should contact their Medicare contractor to determine if they are eligible for an advance or accelerated payment. The Medicare contractor will review the request and provide a decision.
Need More Information?
Still not sure what an NPI is and how you can get it, share it and use it? As always, more information and education on the NPI can be found through the CMS NPI page www.cms.hhs.gov/NationalProvIdentStand on the CMS website. Providers can apply for an NPI online at https://nppes.cms.hhs.gov or can call the NPI enumerator to request a paper application at 1-800-465-3203. Having trouble viewing any of the URLs in this message? If so, try to cut and paste any URL in this message into your web browser to view the intended information.
Note: All current and past CMS NPI communications are available by clicking "CMS Communications" in the left column of the www.cms.hhs.gov/NationalProvIdentStand CMS webpage.
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