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CMS grants some leniency for NPI implementation

Ambulatory Surgery Reimbursement Update, April 10, 2007

The Centers for Medicare & Medicaid Services (CMS) announced April 2 that it will not implement the national providence identifier (NPI) compliance plan that was scheduled to strictly be enforced by May 23, according to the CMS Web site.

The NPI provision requires all insurance claims from providers, including ambulatory surgery centers, to be accompanied by a NPI but CMS' approach will utilize the flexibility granted in section 1176(b) of the Social Security Act to consider good faith efforts.

"For a 12 month period after the compliance date (i.e., through May 23, 2008), CMS will not impose penalties on covered entities that deploy contingency plans (in order to ensure the smooth flow of payments) if they have made reasonable and diligent efforts to become compliant and, in the case of health plans (that are not small health plans), to facilitate the compliance of their trading partners," says CMS' Web site.

To view a copy of CMS' NPI guidance plan, click here.

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