The Medical Group Management Association has sent a letter to CMS offering recommendations for the agency's planned implementation of Health Plan Identifiers, or HPIDs, FierceHealthIT reports (Terry, FierceHealthIT, 5/22).
In April, HHS released a proposed rule that includes a provision that would establish a unique HPID for all health insurers.
According to HHS, the proposed rule "simplifies the administrative process for providers by proposing that health plans have a unique identifier of a standard length and format to facilitate routine use in computer systems" (iHealthBeat, 4/9).
MGMA's Comment Letter
In its letter, MGMA recommended that CMS:
- Recalculate the cost-benefit analysis of its proposal on HPIDs;
- Conduct pilot testing before implementing HPIDs;
- Work with the industry to create feasible timelines for adopting HPIDs; and
- Require health plans to obtain HPIDs before the compliance deadline (FierceHealthIT, 5/22).
The group also suggested that CMS define the term "health plan" to better differentiate between multiple plans operated by a single health insurer. MGMA wrote, "Without knowing which entity performs each role in the revenue cycle, physician practices experience difficulties in processing transactions, reconciling claims and posting payments" (Goedert, Health Data Management, 5/18).
FAH's Comment Letter on NPIs
In related news, the Federation of American Hospitals has sent a letter to CMS raising concerns about a proposed expansion of National Provider Identifiers, or NPIs (Goedert, Health Data Management, 5/22).
An NPI is a 10-digit identification number that will be required for use in all HIPAA-eligible transactions (iHealthBeat, 4/25)
HHS' April proposed rule includes a provision that would require "organization covered" health care providers who prescribe drugs -- such as hospitalists and medical residents -- to obtain an NPI.
In its letter, FAH said that the proposal would require hospital staff to spend a significant amount of time tracking and disclosing individual NPIs for all clinicians that write ambulatory retail prescriptions.
FAH wrote, "Although we understand that retail pharmacy claims may be rejected if prescribers have not obtained an individual NPI ... we feel that it would be overly burdensome for hospitals to assume the responsibility for mandating, tracking and disclosing NPIs to any entity that requires them to process a claim" (Health Data Management, 5/22).