On May 3,2017, Dave Nicholson, CHBME, President and CEO of PMI testified on behalf of the Healthcare Billing and Management Association (HBMA) at the National Committee on Vital and Health Statistics (NCVHS) hearing held at the Health and Human Services (HHS) headquarters in Washington, D.C. The agenda for the day provided hearing participants the opportunity to listen to testimony from the health care industry at the conclusion of the of the Health Plan Identifier three year enforcement discretion period. This is not the first time NCVHS has hosted hearings regarding Health Plan Identifiers (HPIDs), with two hearing taking place during 2014. Feedback obtained from the prior meetings was communicated through a letter to the Secretary of Health and Human Services.
For the current session, each participant was asked to prepare answers to a list of questions to help understand how identifiers are being used in the health care industry on a day to day basis. When describing how health plan identifiers are used today and their purpose, Nicholson stated, “In order to begin meeting the needs of our physician clients, the HPIDs must be used in conjunction with a policy identification number. The HPID is generally sufficient to get you into the ballpark, but the policy identification number is what gets you to the right section, row, and seat. HPIDs are insufficient to get to the level of granular information providers need in order to make patient-specific determinations,”
Nicholson’s recommendation going forward included requiring the Plan ID cards to contain identifiers that allow the provider to easily access the particular product in which the beneficiary is enrolled. He stated “The HPID must direct the provider-electronically- to the appropriate site the first time with minimal to no work on the part of the provider to “figure out” just what plan the patient is enrolled in.”
Nicholson’s full testimony can be found here. NCVHS committee members will review the statements made by all witnesses and will present their recommendations to the Secretary.