The long-awaited release of standard providers' identification numbers is expected within a month.
The Department of Health and Human Services on Wednesday outlined its plan for what information it would release on providers and how that information would be disseminated.
For months, the healthcare industry has been awaiting a formal plan for releasing national provider identifiers and related demographic information. The announcement Wednesday, published in the Federal Register, laid out HHS' plans and rationale for information dissemination.
Widespread distribution of NPIs, required under the Health Insurance Portability and Accountability Act of 1996, is essential for both providers and payers to test and then implement changes so that claims data exchanges include the new numbers. HHS recently issued a contingency plan to delay implementation of a May 23, 2007, requirement that providers and payers use NPIs on all claims.
Data from the National Plan and Provider Enumeration System, or NPPES, is expected for release on June 29, about 30 days after Wednesday's notice was published in the Federal Register. HHS said it plans to release the information in accordance with the Freedom of Information Act and the Privacy Act.
Information will be released through downloadable files on the HHS Web site and also through a query-only database. In the notice, HHS said it also would consider other approaches for releasing the information, if those requests are consistent with the Freedom of Information Act and the Privacy Act.
While NPIs and a variety of other identifying information will be released, the agency said it would not Social Security numbers, Internal Revenue Service individual taxpayer identification numbers and dates of birth. This information won't be released to minimize fraud and abuse in the Medicare and Medicaid programs and in the healthcare industry in general, HHS said.
Beyond that, access to the NPPES data will be relatively open, HHS indicated.
"Anyone may request NPIs and other NPPES healthcare provider data from HHS under the FOIA," the notice said.
Demand for the numbers is expected to be high, HHS admitted, because of the short timeframe needed for the industry to obtain the numbers to test them and make sure they work well with legacy identifiers that various organizations have used for years.
"There is an extreme urgency for HHS to make these data available," the notice indicated. "We believe that making these data available on the Internet is the most efficient and effective means of dissemination."
The notice reminded providers that they have an ongoing responsibility to make sure NPI-related information is updated within 30 days of any changes, and it urged providers to check information in NPPES to ensure the information is current.
HHS said downloadable information would be available in a file on its Web site pages related to NPIs. Each month, it plans to make available a new file containing all updated information; the update file will not replace previous data files.