TIN ComplianceA resource from TIN Comply
TIN compliance by industry

TIN compliance for healthcare

Hospitals, health systems, payers and practice groups pay two kinds of people the IRS and CMS both care about: providers, who need NPI and enrollment checks as well as a TIN, and ordinary vendors, who need everything on this site plus an exclusion screen. Medical and health-care payments also have their own 1099 rule.

Updated September 22, 2026Applies the general guides on this site, with the failure modes and extra checks specific to this sector

What's different here

  • Medical and health care payments are reportable even to corporations. 1099-MISC box 6 covers payments to physicians, other providers and suppliers of medical services, and the corporate exemption doesn't apply. Most AP systems default corporations to "no 1099"; a health-system vendor master needs the override.
  • Providers need more than a TIN match. A provider's TIN can match IRS records while the NPI is inactive, the Medicare enrollment is revoked, or the individual has opted out. Paying, credentialing or billing under that provider is a CMS problem, not an IRS one, and the checks are separate databases (NPPES, PECOS, the opt-out list).
  • Exclusion screening is mandatory, not optional. HHS-OIG's LEIE and the state Medicaid exclusion lists must be checked at hire or contract and monthly thereafter for anyone whose work is billed to federal healthcare programs; payments to an excluded party are non-reimbursable and can trigger civil monetary penalties. OFAC still applies on top.
  • Locum tenens, 1099 physicians and group practices produce the classic line-1 problem: the physician's SSN with the practice name, or the practice EIN with the physician's name. See the W-9 name guide.
  • Patient refunds and settlements are generally not 1099 reportable, but attorney settlements are (box 10, gross proceeds), and the attorney's TIN needs verifying like any other.

A vendor-onboarding sequence that covers both regimes

  • Collect the W-9 (or W-8 for foreign providers and researchers) and verify the name/TIN pair against IRS records before setup.
  • For clinicians and clinical vendors: validate the NPI in NPPES, confirm Medicare enrollment status in PECOS, check the opt-out list, and record the dates.
  • Screen the entity and its principals against OFAC SDN/Consolidated, SAM.gov, the OIG LEIE and your state's Medicaid exclusion list; re-screen monthly.
  • Flag corporations that receive medical payments so the 1099-MISC box 6 rule applies at year end.
  • Keep the W-9, the match result, the NPI/PECOS checks and the exclusion screens in one record; a CMS audit and an IRS notice will each ask for their half.

Notices you'll see

  • CP2100 listings dominated by individual providers paid through group practices, and by vendors set up from an invoice rather than a W-9.
  • Notice 972CG amounts driven by the volume of 1099-MISC box 6 filings; the medical-payment rule means health systems file far more 1099s than businesses of similar size.