CMS said on August 4 that it's ending the contingency plan for electronic Medicare claims that do not comply with the HIPAA transaction and code sets (TCS) regulation. Beginning October 1, 2005, CMS will not process incoming electronic Medicare claims if they're not in a HIPAA-compliant format.

The HIPAA TCS regulation, which took effect October 16, 2003, mandated a switch to a universal format for electronic claims, ending the patchwork of claims formats used by different insurers across the country. CMS has said that noncompliant claims will be returned, unprocessed, to the filer for re-submission as compliant claims. CMS implemented the contingency plan in October 2003 when it became clear that many providers and plans were not ready to go live by the deadline.