AAFP Joins AMA, Other Medical Organizations in Calling On HHS to Delay NPI Deadline

The AAFP has joined the AMA and 35 other national medical organizations in urging HHS Secretary Michael Leavitt to delay a fast-approaching deadline that would require Medicare providers to file Medicare claims using only their National Provider Identifier, or NPI, number.

In a letter dated May 1, the medical organizations cited their growing concerns about the ability of physician practices, clearinghouses and commercial insurance payers to meet the May 23 deadline.

"We urge you to allow physician practices and others to continue to submit transactions that contain both legacy and NPI numbers for a minimum of six additional months after May 23," said the letter. "Furthermore, we urge you to closely monitor the readiness level of covered entities and take all appropriate steps necessary to ensure that the industry does not experience wide-scale disruption in claims processing and payment during this time."

Supporters of the proposed delay, including the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists and the American College of Physicians, pointed out that by Medicare's own estimates, only about 20 percent of claims currently are submitted with just an NPI number.

"With the May 23 deadline less than a month away, it is highly unlikely that the volume of claims being sent successfully with just an NPI (number) will reach an acceptable level," said the letter.

The medical organizations also noted that Medicare is advising providers to re-enroll in Medicare if they encounter problems matching their old legacy numbers to their new NPI numbers. These instructions could leave many physicians in the middle of the enrollment process as of May 23, and small practices, in particular, "simply cannot afford a cash-flow interruption spanning a month or more," said the letter.

In addition to delaying enforcement of NPI-only claims, the medical organizations asked CMS to use the recommended six-month extension to monitor the number of claims submitted with just an NPI number and to track the number of NPI-only claims that are rejected.

The organizations asked Levitt to retain the current contingency plan until it becomes clear that the vast majority of Medicare claims being submitted with an NPI number alone are processed successfully.

They also requested that Medicare closely monitor claims rejection rates and processing interruptions should CMS hold firm to the current the May 23 deadline. CMS must be prepared to allow claims to be resubmitted with the NPI and legacy numbers together if there are significant interruptions, said the organizations.

"We recognize that CMS does not want to extend the (NPI) deadline, but we continue to be very concerned that the claims processing system will be interrupted," said the letter, adding that such a scenario could negatively affect patient care.