OIG Weighs in on Invalid Prescriber Identifiers

For those clients who have asked about support for demanding valid prescriber identifiers in pharmacy claims, the OIG has been kind enough to offer their assistance. According to the OIG acceptable physician identifiers require that the number and physician are listed in the approved registries.  See more below.

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OIG Issues Report – Invalid Prescriber Identifiers On Medicare Part D Drug Claims

The Office of the Inspector General conducted a record review to determine the extent to which invalid prescriber identifiers were used on Part D prescription drug event (PDE) records in 2007.  They considered prescriber identifiers to be invalid if they did not appear in any of the approved registries.  Acceptable prescriber identifiers include National Provider Identifiers (NPI), Drug Enforcement Administration (DEA) registration numbers, Unique Physician Identification Numbers (UPIN), and State license numbers. Prescriber identifiers that were deactivated or retired before January 1, 2006, were also considered to be invalid.

source: http://oig.hhs.gov/oei/reports/oei-03-09-00140.pdf

Craig S. Stern, PharmD, MBA
President
Pro Pharma Pharmaceutical Consultants, Inc.