Literature DB >> 33732592

The Misclassification of Behavior Analysts: How National Provider Identifiers (NPIs) Fail to Adequately Capture the Scope of the Field.

Erick M Dubuque1, Marissa E Yingling2, R Allan Allday3.   

Abstract

To remain in compliance with the Health Insurance Portability and Accountability Act of 1996, U.S. health care providers are required to register for a National Provider Identifier (NPI). When applying for an NPI, providers must select the Healthcare Provider Taxonomy Code(s) that most closely describes the services they offer. Three distinct taxonomies describe the services offered by behavior analysts. Two of these codes, the Behavior Analyst (103K00000X) and the Assistant Behavior Analyst (106E00000X) taxonomies, specify that the health care provider must hold either a certification from the Behavior Analyst Certification Board or a state-issued credential to practice behavior analysis. The purpose of this study was to investigate the concordance between health care providers who utilize these behavior-analytic NPI taxonomy classifications and health care providers who meet the credential qualifications specified in the code descriptions. Results indicated that there are potentially more than 20,000 U.S. health care providers who do not hold the behavior analyst credentials specified in the taxonomy descriptions linked to their accounts. The implications of providers being mistakenly classified as credentialed behavior analysts and credentialed assistant behavior analysts in federal data and how the field should respond are discussed. © Association for Behavior Analysis International 2020.

Entities:  

Keywords:  Applied behavior analysis; HIPAA; Health insurance; NPI; Taxonomy

Year:  2020        PMID: 33732592      PMCID: PMC7900299          DOI: 10.1007/s40617-020-00451-w

Source DB:  PubMed          Journal:  Behav Anal Pract        ISSN: 1998-1929


  5 in total

1.  Geographic Variation in the Supply of Selected Behavioral Health Providers.

Authors:  C Holly A Andrilla; Davis G Patterson; Lisa A Garberson; Cynthia Coulthard; Eric H Larson
Journal:  Am J Prev Med       Date:  2018-06       Impact factor: 5.043

2.  Proximity of providers: Colocating behavioral health and primary care and the prospects for an integrated workforce.

Authors:  Benjamin F Miller; Stephen Petterson; Bridget Teevan Burke; Robert L Phillips; Larry A Green
Journal:  Am Psychol       Date:  2014 May-Jun

3.  Primary care, behavioral health, provider colocation, and rurality.

Authors:  Benjamin F Miller; Stephen Petterson; Shandra M Brown Levey; Jessica C Payne-Murphy; Miranda Moore; Andrew Bazemore
Journal:  J Am Board Fam Med       Date:  2014 May-Jun       Impact factor: 2.657

4.  Using the National Provider Identifier for health care workforce evaluation.

Authors:  Andrew B Bindman
Journal:  Medicare Medicaid Res Rev       Date:  2013-07-30

5.  Precision of provider licensure data for mapping member accessibility to Medicaid managed care provider networks.

Authors:  Nathaniel Bell; Ana Lòpez-DeFede; Rebecca C Wilkerson; Kathy Mayfield-Smith
Journal:  BMC Health Serv Res       Date:  2018-12-17       Impact factor: 2.655

  5 in total

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