According to a June 11 CMS announcement, doctors will have to reconcile their NPI data with their IRS legal name data in order to get paid.
It is a befuddling regulation since, as an employed physician, 100% of my billings have gone to organizations that paid me a salary. Why check my provider identifier with my tax information. They don't correlate. I can pretty much promise you that they never have and sometimes the discrepancies have been fairly substantial. When I worked at a residency, I could bill enormous amounts of money for services I supervised, but was paid a pretty paltry academic salary for the privilege.
I am sure this will be a huge problem for docs in practice who bill under their name and get paid directly. Any discrepancy in any character in the field will ensure non-payment. This is not the kind of thing your laptop spell check will prevent. If this regulation is enforced to the letter, it will assure that services are provided free of charge.
I bet that this billing "error" can also be enforced as fraud and abuse, leading to criminal charges, treble penalties, and time in jail. I hear PhD nurses want to get into the practice of medicine... could you please remind me why anyone would want to do this?
And I thought insurance companies were the best at playing the game of using regulation as an excuse to get out of fulfilling their obligations. CMS must be attracting former insurance executives.
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