Doug is always right! >>> "Doug Webb" <[EMAIL PROTECTED]> 09/23/03 01:21PM >>> MessageJenn, It is indeed an assumption that could be made, but I'm not at all sure that it's a safe one. Each Medicaid program is administered by State agencies, so I think that readiniess statements and /or contingency plans would have to come from each individual Plan administrator.
The opinions expressed here are my own and not necessarily the opinion of LCMH. Douglas M. Webb Computer System Engineer Little Company of Mary Hospital & Health Care Centers [EMAIL PROTECTED] "This electronic message may contain information that is confidential and/or legally privileged. It is intended only for the use of the individual(s) and entity(s) named as recipients in the message. If you are not an intended recipient of the message, please notify the sender immediately, delete the material from any computer, do not deliver, distribute, or copy this message, and do not disclose its contents or take action in reliance on the information it contains. Thank you." ----- Original Message ----- From: Jones, Jennifer To: Doug Webb ; WEDI SNIP Transactions Workgroup List Sent: Tuesday, September 23, 2003 12:10 PM Subject: RE: MEDICARE ANNOUNCES PLAN TO ACCEPT HIPAA NON-COMPLIANT ELECTRONIC I know he didn't specifically say Medicaid but they are covered under CMS.I just assumed that being able to accept non-compliant formats was for both Medicare and Medicaid. Is that not a safe assumption? --- jenn ____________________ Jennifer Lynne Jones Sanitas Product Manager Pinpoint Technologies Boulder, CO 80301 303-801-1829 (Direct) 303-801-0001 (Fax) -----Original Message----- From: Doug Webb [mailto:[EMAIL PROTECTED] Sent: Tuesday, September 23, 2003 11:05 AM To: WEDI SNIP Transactions Workgroup List Subject: Re: MEDICARE ANNOUNCES PLAN TO ACCEPT HIPAA NON-COMPLIANT ELECTRONIC Rachel, My crystal ball agrees with yours. We must be on the same channel. Now, if we can hear something similar from the Mediciads and some of the Payers out there (especially the large-volume ones), we might get out of the train wreck sane yet! As to the "muscle" that is likely to be applied eventually, another form would be what Medicare did pre-HIPAA -- a combination of a guaranteed maximum adjudication time for clean 837s, and a guaranteed minimum time for paper claims (Medicare used 15 and 30 days, respectively). The opinions expressed here are my own and not necessarily the opinion of LCMH. Douglas M. Webb Computer System Engineer Little Company of Mary Hospital & Health Care Centers [EMAIL PROTECTED] "This electronic message may contain information that is confidential and/or legally privileged. It is intended only for the use of the individual(s) and entity(s) named as recipients in the message. If you are not an intended recipient of the message, please notify the sender immediately, delete the material from any computer, do not deliver, distribute, or copy this message, and do not disclose its contents or take action in reliance on the information it contains. Thank you." ----- Original Message ----- From: Rachel Foerster To: WEDI SNIP Transactions Workgroup List Sent: Tuesday, September 23, 2003 10:41 AM Subject: RE: MEDICARE ANNOUNCES PLAN TO ACCEPT HIPAA NON-COMPLIANT ELECTRONIC In effect, the net result of CMS implementing its HIPAA TCS contingency plans is that it lets the entire industry off the hook for compliance. The "reasonable time frame" aspect will be interesting to observe re how long that time frame will be. On the other hand, the big payers will only let the submitters/providers slide so long and then they must be able to begin leveraging their investment in the new EDI technical infrastructure. My crystal ball is that this *bye* will last through the end of 2003 and then the big payers will start muscling tie providers - either through new provider network participation contracts which will required all EDI submissions or by a substantial surcharge for each paper claim - or both. What do you think? Rachel Rachel Foerster Chief Executive Officer Rachel Foerster & Associates, Ltd. Ideas - Products - Innovation 39432 North Avenue Beach Park, IL 60099 Voice: 847-872-8070 email: [EMAIL PROTECTED] http://www.rfa-edi.com -----Original Message----- From: Marcallee Jackson [mailto:[EMAIL PROTECTED] Sent: Tuesday, September 23, 2003 9:02 AM To: WEDI SNIP Transactions Workgroup List Subject: MEDICARE ANNOUNCES PLAN TO ACCEPT HIPAA NON-COMPLIANT ELECTRONIC MEDICARE NEWS FOR IMMEDIATE RELEASE CMS Public Affairs Office September 23, 2003 MEDICARE ANNOUNCES PLAN TO ACCEPT HIPAA NON-COMPLIANT ELECTRONIC TRANSACTIONS AFTER OCTOBER 16 COMPLIANCE DEADLINE The Centers for Medicare & Medicaid Services (CMS) announced today that it will implement a contingency plan to accept noncompliant electronic transactions after the October 16, 2003 compliance deadline. This plan will ensure continued processing of claims from thousands of providers who will not be able to meet the deadline and otherwise would have had their Medicare claims rejected. "Implementing this contingency plan moves us toward the dual goals of achieving HIPAA compliance while not disrupting providers' cash flow and operations, so that beneficiaries can continue to get the health care services they need," said CMS Administrator Tom Scully. CMS made the decision to implement its contingency plan after reviewing statistics showing unacceptably low numbers of compliant claims being submitted. "Medicare is able to process HIPAA-compliant transactions," said Tom Grissom, director of CMS' Center for Medicare Management, "but we need to work with our trading partners to increase the percentage of claims in production." The contingency plan permits CMS to continue to accept and process claims in the electronic formats now in use, giving providers additional time to complete the testing process. CMS will regularly reassess the readiness of its trading partners to determine how long the contingency plan will remain in effect. The authority to implement a contingency plan was provided by guidance issued by HHS on July 24. CMS recognized that transactions often require the participation of two covered entities and that non-compliance by one covered entity may put the second covered entity in a difficult position. The guidance stated that covered entities that make a good faith effort to comply with HIPAA transactions and code set standards may implement contingencies to maintain operations and cash flow. CMS announced its contingency plan on September 11, but at that time had not made a decision on whether the plan would be implemented. Today's announcement means the CMS plan will be implemented on October 16, 2003. "We encourage other plans to assess the readiness of their trading partners and implement contingency plans if appropriate," Grissom said. ### Marcallee Jackson Director, Healthcare Solutions Edifecs, Inc Office (425) 452-0632 Cell: (425) 681-4858 [EMAIL PROTECTED] --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. 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