The Centers for Medicare and Medicaid Services has issued a final rule tightening requirements for providers and suppliers to use a national provider identifier.
The final rule, mandated under the Affordable Care Act, follows implementation of an interim final rule in May 2010 that generated about 224 comments.
“It requires all providers of medical or other items or services and suppliers that qualify for a national provider identifier to include their NPI on all applications to enroll in the Medicare and Medicaid programs and on all claims for payment submitted under the Medicare and Medicaid programs,” according to the rule. “In addition, it requires physicians and other professionals who are permitted to order and certify covered items and services for Medicare beneficiaries to be enrolled in Medicare. Finally, it mandates document retention and provision requirements on providers and suppliers that order and certify items and services for Medicare beneficiaries.”
The goal of the rule is to improve Medicare and Medicaid program integrity and ensure only qualified providers and suppliers participate. The rule is available here.
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