The original question related to a practice with < 10 employees. Wouldn't the following language taken from ASCA seem to indicate that CMS must make an exception with respect to accepting paper claims from small practices? (See sections below highlighted with <<<>>>)
SEC. 3. REQUIRING ELECTRONIC SUBMISSION OF MEDICARE CLAIMS. (a) IN GENERAL- Section 1862 of the Social Security Act (42 U.S.C. 1395y) is amended-- (1) in subsection (a)-- (A) by striking `or' at the end of paragraph (20); (B) by striking the period at the end of paragraph (21) and inserting `; or'; and (C) by inserting after paragraph (21) the following new paragraph: `(22) subject to subsection (h), for which a claim is submitted other than in an electronic form specified by the Secretary.'; and (2) by inserting after subsection (g) the following new subsection: <<<`(h)(1) The Secretary-- `(A) shall waive the application of subsection (a)(22) in cases in which-- `(i) there is no method available for the submission of claims in an electronic form; or `(ii) the entity submitting the claim is a small provider of services or supplier; and>>> `(B) may waive the application of such subsection in such unusual cases as the Secretary finds appropriate. <<<`(2) For purposes of this subsection, the term `small provider of services or supplier' means-- `(A) a provider of services with fewer than 25 full-time equivalent employees; or `(B) a physician, practitioner, facility, or supplier (other than provider of services) with fewer than 10 full-time equivalent employees.'.>>> (b) EFFECTIVE DATE -----Original Message----- From: David Frenkel [mailto:[EMAIL PROTECTED]] Sent: Thursday, October 10, 2002 10:16 AM To: [EMAIL PROTECTED] Subject: RE: HIPAA Exemption >From the CMS FAQ: ASCA prohibits HHS from paying Medicare claims that are not submitted electronically after October 16, 2003, unless the Secretary grants a waiver from this requirement. It further provides that the Secretary must grant such a waiver if there is no method available for the submission of claims in electronic form or if the entity submitting the claim is a small provider of services or supplies. Beneficiaries will also be able to continue to file paper claims if they need to file a claim on their own behalf. The Secretary may grant such a waiver in other circumstances. We will publish proposed regulations to implement this new authority. Regards, David Frenkel Business Development GEFEG USA Global Leader in Ecommerce Tools www.gefeg.com 425-260-5030 -----Original Message----- From: Aaron Johnson [mailto:[EMAIL PROTECTED]] Sent: Thursday, October 10, 2002 10:03 AM To: [EMAIL PROTECTED]; Alex Kaplun Subject: RE: HIPAA Exemption After reading your responses to Jonathan, I think you should rethink your answer. Here is the real answer, check it out, let me know if you have any questions. Jonathan, No, Medicare and just spent $78 Million to upgrade their system and applications, and will not accept paper claims after October of next year. There is a lot about HIPAA you need to know, transmitting claims is just a very small piece of the HIPAA pie. I would start reading and searching on the web. This is not an overnight process, its not even an over a couple of weeks process, so get educated. HIPAA has introduced over 80,000 ways to be incompliant, with fines up to $25,000 for each. You have to remember, your dealing with civil rights issues. Our team is already helping practices whip the HIPAA thing. I am not sure where you are located geographically but let me know, maybe we can help. Good Luck. Check out these sites, maybe they will help you get a start: www.hhs.gov/ocr/hipaa/index.html www.jcaho.org http://fortress.wa.gov/dshs/maa/dshshipaa/ Aaron Johnson e-Solutions Manager, CSI office: 904.794.5044 x370 cell: 904.669.5590 4475 South US 1, suite 100 St. Augustine, FL 32086 "The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential, proprietary, and/or privileged material. Any review, retransmission, dissemination or other use of, or taking of any action in reliance upon, this information by persons or entities other than the intended recipient is prohibited. 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