Medicare NPI registry reveals confidential information

Medicare

The NPI Registry is opening up personal information to anyone listening in. Image from Flickr.

The NPI registry, or National Provider Identification registry, is a digital database of all Medicare providers. In a system that handles hundreds of millions of pieces of confidential information, though, there are weaknesses. The newest NPI database discloses extra information that opens the door for Medicare fraud.

The NPI registry

The Medicare system is a very complicated bureaucratic maze that depends on the NPI registry, National Supplier Clearinghouse numbers and Medicare Administrative Contractors. Released very recently, the NPI Registry database is called the National Plan and Provider Enumeration System. The NPPES was intended to simplify the payment of Medicare claims. In the end, though, the NPPES also gives out the National Supplier Clearinghouse number of a provider, which opens up both patient and provider information that should be confidential.

NPI registry information

The National Provider Identification registry works along with several other cogs in the Medicare system. With just the NSC number and a patient’s claim number, anyone can access information on payment of claims, a patient’s diagnosis and procedures, and more. In other words, the new NPI registry opens up the bones of the Medicare payment system to possible exploitation.

Fixing problems in the NPI registry

Contacting the three major arms of the Medicare payment system to ask about the NPI registry problem resulted in being given the runaround, according to Home Care Magazine. The suggestion of deleting the NPI information from the database, though, means that a provider might not get paid. In other words, this means that providers have to decide between being paid by Medicare for services they provide, or protecting the personal information of the doctors and patients. Though several solutions easily coded by dedicated programmers have been suggested, the NPI registry has not said they will be implementing any of them.

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