The two most viable options are described below. The Notice of Proposed Rule Making welcomes feedback on these options, as well as on alternate solutions. Because the data needed to enumerate Medicare providers is already available in HCFA files, that information will be loaded into the National Provider System and NPIs will be assigned automatically to Medicare providers under either option described below. Medicare providers, therefore, would not have to apply for an NPI.
Option 1: A Federally-directed registry would be the enumerator of all health care providers.
After the initial load of Medicare provider data and assignment of NPIs to Medicare providers, all the remaining health care providers would apply directly to the registry for an NPI. The registry could be operated by an agent or contractor. The registry would enter the provider’s data into the National Provider System; the National Provider System would assign an NPI, and the registry would notify the provider of the NPI.
Option 2: A combination of Federal programs (health plans), Medicaid State agencies, and a registry would be enumerators.
Federal programs and Medicaid State agencies would enumerate their own health care providers by entering provider data into the National Provider System; the National Provider System would assign NPIs to the providers. Each health care provider participating in more than one Federal or Medicaid health plan could choose the one by which it wishes to be enumerated. All other health care providers would apply directly to a Federally-directed registry for an NPI.