NPI: Get It. Share It. Use It Posting Date: July 2006 As the industry transitions to NPI compliance, remember that there is no charge to get an NPI. Providers can apply online for their NPI, free of charge, by visiting https://nppes.cms.hhs.gov or by calling 1-800-465-3203 to request a paper application. The CMS NPI page, located at http://www.cms.hhs.gov/NationalProvIdentStand/, is the only source for official CMS education and information on the NPI initiative; all products located on this site are free of charge. CMS continues to urge providers to include legacy identifiers on their NPI applications, not only for Medicare but for all payors. If reporting a Medicaid number, include the associated State name. If providers have already applied for their NPI, CMS asks them to go back into the NPPES and update their information with their legacy identifiers. This information is critical for payors in the development of crosswalks to aid in the transition to the NPI. Getting an NPI is free - not having one can be costly.

To All Healthcare Providers: Posting Date: July 2006 The National Provider Identifier (NPI) rule does not change the Indiana Health Coverage Programs (IHCP) provider enrollment policies. To receive reimbursement from the IHCP, a provider must be enrolled (405 IAC 5-4-1). Obtaining an NPI does not guarantee enrollment in the IHCP. A provider is enrolled when the following conditions are met and are applicable to the provider type: The provider is licensed, registered, or certified by the appropriate professional regulatory agency pursuant to state or federal law or otherwise authorized by the Indiana Family and Social Services Administration (IFSSA) or the Indiana State Department of Health (ISDH). Out-of-state providers must be certified, licensed, registered, or authorized as required by the state in which the provider is located and must fulfill the same conditions as an in-state provider. A list of eligible out-of-state provider types is available in Chapter 4 of the IHCP Provider Manual. The IHCP Provider Manual is accessible on the IHCP Web site at http://www.indianamedicaid.com. The provider has completed, signed, dated, and returned the original provider agreement and all forms as required by the IFSSA or the ISDH. As a condition of enrollment, providers must sign an agreement (the agreement cannot be altered) to provide services to all IHCP covered and Hoosier Healthwise Package C covered services and/or supplies to IHCP and Hoosier Healthwise Package C members. Applicable provider re-certification requirements as specified by the IHCP and the provider agreement have been satisfied. Having an NPI does not: Ensure a provider is licensed or credentialed Guarantee payment by IHCP Enroll a provider in the IHCP Turn a provider into a covered provider Require a provider to conduct Health Information Portability and Accountability Act (HIPAA) standard transactions Refer to Chapter 4 of the IHCP Provider Manual for more information about the IHCP provider enrollment policies. Chapter 4 of the IHCP Provider Manual is accessible online at http://www.indianamedicaid.com/ihcp/Manuals/Provider/chapter04.pdf.

CMS News for Health Industry Organizations Posting Date: May 2006 Effective May 1, 2006, the Centers for Medicare & Medicaid Services (CMS) announces the capability for health industry organizations to submit health care provider applications for National Provider Identifiers (NPIs) to the National Plan and Provider Enumeration System (NPPES) via electronic file interchange (EFI). With EFI, a CMS-approved health industry organization can submit a health care provider's NPI application data, along with the application data of many other health care providers, in a single electronic file in a CMS-specified format. EFI is an alternative to health care providers having to apply for their NPIs via the Web-based or paper application process. After the NPPES processes a file, it makes available to the organization a downloadable file containing the NPIs of the enumerated health care providers. Interested health industry organizations should avail themselves of the EFI materials available from the CMS NPI page (http://www.cms.hhs.gov/NationalProvIdentStand) and from the NPPES page (https://nppes.cms.hhs.gov) before downloading and completing the Certification Statement (available at https://nppes.cms.hhs.gov) and registering as EFI organizations. A completed Certification Statement must be approved by CMS before an interested health industry organization can participate in EFI.