HB18-1282: Health Care Provider Unique Identification Per Site or Service

Position: Support

Summary: Requires off-campus hospital locations (including FSEDs) to obtain their own unique NPI (National Provider Identifier) for billing, reimbursement, and all claims purposes related to the health care services that they provide at that location. The off-campus NPI must use their NPI for any health services provided at their location, regardless if the claim is filed at the hospital’s main billing or claims department.

Also requires all Medicaid providers to obtain their own unique NPI for each site they deliver services, and for each provider type that HCPF specifies.

The purpose is that currently these off-campus locations & FSEDs are using the same NPI as the main hospital campus. Therefore, there is no way to track the costs associated with these off-campus locations/FSEDs or the main reasons why patients are visiting them. With a unique NPI, we’ll be able to collect data associated with these specific sites, understand the costs associated with them and what is driving overall costs within hospital systems. It’s the first step in creating a more transparent process for patients and policymakers, which can inform next steps to address them.

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