HIPAA—CMS Says Don't Expect Any Delays On October Deadline

Article from PREFERRED Network News (PNN) September 2003, A PREFERRED Therapy Providers Newsletter

HIPAA—CMS Says Don't Expect Any Delays On October Deadline

There isn't a lot of time left for covered entities to prepare for the Oct. 16 Transaction and Code Set deadline, Karen Trudel, director of HIPAA outreach at the Centers for Medicare and Medicaid Services (CMS), said at CMS' eighth HIPAA roundtable discussion.

"Some people have said that HIPAA will go away, or Congress will give us more time, or we don't have to worry about this right now. Well, my response to that is first, HIPAA is the law. It could be said that Congress has already given us more time; time that is up on Oct. 16, and it began last Oct. 16, 2002, with the extension," she said.

"Deciding to ignore these requirements is a real gamble, and it's one with high stakes because cash flow is the lifeblood of a healthcare provider and a healthcare claim is how that blood flows. If the flow of claims stops because of a non-compliance issue, then the cash flow stops too," Trudel warned.

The only way to assure that this does not happen is to implement compliant transactions and then to test them with the health plan to make sure the claims can be submitted and processed and the accurate payment can be made, she explained.

"We're hearing that many plans and providers aren't yet ready to test with training partners. In part that's because covered entities and their vendors and business associates, some of them, waited until the regulation that modified the transaction standards were published," Trudel said.

"Well, here's where we are now. The addenda have been published and the standards are set for compliance. So, it's time to test now. Medicare's ready to test the claim and remittance advice with providers using the new 4010A addenda version," she noted.

"The longer you wait the harder it will be to arrange testing. We expect a crowd of testers at the last minute and it may be difficult to accommodate them all. Don't underestimate the importance of the Oct. 16 deadline. Don't underestimate the work that's involved in becoming compliant. And prepare and plan ahead to assure that your cash flow remains steady," she added.