COMMUNITY PRACTICE

New provider numbers are on the way

Pharmacists will be able to say good riddance to those pesky physician Drug Enforcement Administration identification numbers on prescription drug claims thanks to a new venture launched by the National Council for Prescription Drug Programs (NCPDP). This is the association that sets standards for electronic pharmacy transactions.

The new initiative has been labeled the HCIdea Directory. Its concept is to develop, support, and distribute unique identification numbers for every prescriber in the United States.

Announced at NCPDP's recent annual meeting, the HCIdea Directory will be a national database to help facilitate prescription drug claims processing by replacing DEA numbers as a way to identify prescribers.

Eliminating use of DEA numbers will be a big plus for everyone along the Rx claim processing route, including pharmacists, said Phillip Scott, NCPDP's newly appointed executive v.p. of health-care relations and development. Pharmacies will be able to clean up their files, claims won't get bounced for lack of a valid prescriber number, and prescribers will finally be matched to their correct locations.

"The DEA has been threatening for a number of years to shut down use of its numbers [as identification]," Scott told Drug Topics. "And some states are already actively seeking to do that. It's not until they realize the potential chaos it would cause to eliminate [the DEA number] as the sole source of physician identification that they tend to back off a bit. The DEA issue around claims adjudication is real. So far, we've managed to put it off, but only for a while."

The DEA is already getting serious about misuse of the numbers it assigns to providers authorized to prescribe controlled substances. "Through a series of interviews, we've been told that the DEA has started to fine pharmacies $10,000 for every instance of misuse of the DEA number or of inaccurate DEA numbers within their files," Scott said. "As I understand it, in order to get a claim adjudicated, pharmacies will use a dummy DEA number so the claim flows through. If you look at the intended use of the DEA number, you can understand why this would not be acceptable. Inaccurate DEA numbers in pharmacy files can lead to misallocation of controlled substance prescribing. "

The HCIdea Directory will be up and running by the end of the year, Scott predicted. Although partnerships with technical firms have not been finalized, the framework will most likely be a central database accessible by subscription. He's hopeful the data warehouse will be housed on the Internet where users can tap into a secure site to electronically update their prescriber files. In the most likely scenario, pharmacy system vendors will update prescriber files on a regular basis, so their clients won't have to change the way they use their own pharmacy systems.

"Virtually anyone in the process of touching a prescription is a potential client," Scott said. "It will have value for PBMs, pharmaceutical companies, information services, pharmacies, insurance companies, and third-party payers. The reaction has been incredible. We've had offers of help to get the numbers out, offers to use databases, offers of funding to help us until we get it operational. We are extremely gratified."

The latest move into prescriber-IDland came after NCPDP's two previous attempts to collaborate with the American Medical Association on a prescriber enumerator system failed. When the last round of discussions with the AMA failed, NCPDP's board of trustees broke off negotiations and voted last fall to move forward with the HCIdea initiative, Scott said.

Carol Ukens

Carol Ukens. New provider numbers are on the way.

Drug Topics

2001;8:27.