TO:        ALL

Happy New Year!!!

For those interested with healthcare-related projects for IT and E-Commerce,
please review the following messages.

Thanks,

David Paraiso
http://www.edi-info-center.com
[EMAIL PROTECTED]
Hotline: (800) 949-9278
FAX: (626) 918-6115


----- Original Message -----
From: Jeffrey Young
To: HIPAAlive Discussion List
Sent: Thursday, January 03, 2002 10:45 PM
Subject: [hipaalive] RE: Transactions Compliance Extension


*** HIPAAlive! From Phoenix Health Systems/HIPAAdvisory.com ***


David S.:

Medicaid and Medicare are both federally funded health care programs.
Medicaid is operated by each state, while Medicare is operated directly by
CMS.  The State of Tennessee is the "TPA (third party administrator)" if you
will, for Medicaid recipients in that state.   As the largest payer in the
US (CMS as the owner of Medicaid and Medicare covers almost 40 million
people because of Medicaid's role as payer of last resort), the HIPAA regs
specifically name Medicare and Medicaid as covered entities.  The agency
that operates the Medicaid program varies by state (in OR for example, it is
the Health Services Division of the Department of Human Services).


David F.:

You're right.  The dominoes are more like an avalanche when you look at the
numbers:

650 Indemnity Carriers
1500 HMOS
750 TPAs
50,000 Self administered plans
5,700 acute care hospitals
18,400 skilled nursing facilities
9,000 hospices
22,000 residential mental health/substance abuse faciliities
44,000 pharmacies
9,500 medical labs
7,900 dental labs
112,000 DME providers
214,000 physician practices
120,000 dental practices
18,000 Optometrists
50,000 other practices

Total count: approximately 683,400 organizations that in theory could apply
for an extension after they've 1) assessed their compliance 2) developed an
implementation plan and 3) determined they can't make the date.

If survey data holds true, only 15% of these organizations have actually
started addressing their compliance.  That leaves 450K plus who have those
steps to complete and won't be ready to file an application tomorrow if they
had to.  They are about 90 days behind everybody else who have achieved that
step.

If just five percent (and this is a very conservative number) of these
organizations apply for extensions prior to October 16th, that would be
34,000 extensions to be reviewed and approved by HHS.

However, the format for an extension won't be available until mid-March.
That leaves only 8 months to process all the extension applications.

In an average distribution, that's over 4K per month and 200 applications a
day every business day until the deadline.  If you take some of the
estimates that say more than half of all major payors and institutional
providers can't make the deadline, that number could reach 100K depending on
whether owned and affiliated organizations file as a single covered entity.
HHS is not equipped to deal with that kind of volume in either case given
all the reviewers defined by ACSA.

It doesn't make an extension a very viable option, but reinforces that the
combination of using clearinghouses to translate formats AND changing key
business processes and rules to match the HIPAA standards, are the most
likely routes to achieve compliance.

Funny thing is that X12N is an industry represented committee and payers are
having as hard a time getting this under control as the providers.  Just
from my exposure to a select organizations, I'm learning that more education
on the structure of the transaction and the definition of its elements is
needed to truly figure out what the real gaps are.

Just a thought.

Jeffrey Young
BEST Consulting
700 NE Multnomah
Suite 1100
Portland, OR 97232
Telephone: (503) 236-5787



-----Original Message-----
From: David A. Feinberg, C.D.P.
Sent: Thursday, January 03, 2002 8:42 PM
To: HIPAAlive Discussion List
Subject: [hipaalive] RE: Transactions Compliance Extension


*** HIPAAlive! From Phoenix Health Systems/HIPAAdvisory.com ***

>From section 2 of the Administrative Simplification Compliance Act
(ASCA, also known as HR3323):

     "... a health care provider, health plan (other than a small
      health plan), or a health care clearinghouse shall not be
      considered to be in noncompliance with the"  electronic
      transactions and code sets regulations  "only if, before
      October 16, 2002, the person [i.e., the provider, health
      plan or clearinghouse] submits ... a plan of how the person
      will come into compliance ... not later than October 16, 2003."

But all of us need to continue to keep in mind that non-standard
transactions translated in to or out of standard transactions by a
HIPAA clearinghouse are compliant.  [Beyond this, though, I, too, am
beginning to smell the onset of a big game of falling dominoes :-).]

                          Dave Feinberg
                          Rensis Corporation [A Consulting Company]
                          206-617-1717





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