CMS and HIPAA

[david derauf]

So the press leaks notwithstanding, CMS enforces HIPAA rule. One wonders if the leaks were not designed to falsely reassure physicians and hospitals and now insurers can deny payments to those 50% noncompliant without fear of legal redress.   "On HIPAA, CMS maintains Medicare claims rule October 17, 2003 CMS on Wednesday reiterated its position that it will no longer accept paper Medicare claims, except in limited circumstances, after the deadline for the HIPAA transactions and code sets rule, which went into effect Thursday, Modern Physician reports. The agency also said it does not plan to change the interim final rule that it issued in August. As CMS said last month, it will continue to accept claims that aren�t in HIPAA-standard format for an undetermined period of time as long as health care organizations are making good-faith efforts to comply with the rule. Practices with fewer than 10 full-time-equivalent employees and cases in which there is no system for filing claims electronically are exempt from the rule. The 60-day comment period on the transactions rule closed Tuesday (Versel, Modern Physician, 10/16). The American Hospital Association on Monday sent a letter to CMS asking the agency to clarify how it will reconcile the interim final HIPAA transactions and code sets rule with its contingency plan for continued claims processing after the rule�s Oct. 16 deadline. In the letter to CMS Administrator Tom Scully, AHA called the interim final rule �inconsistent with CMS�s plan� (iHealthBeat, 10/15)."