The Illinois Department of Public Aid has said they will announce on or
before 10/1 if they will put their contingency plans in place.
Lisa R. Cavitt
Southern Illinois Healthcare
"Phillip Otto"
<[EMAIL PROTECTED] To: "WEDI SNIP Transactions
Workgroup List"
v> <[EMAIL PROTECTED]>
cc:
09/23/03 02:14 PM Subject: Re: MEDICARE ANNOUNCES PLAN
TO ACCEPT HIPAA
Please respond to NON-COMPLIANT ELECTRONIC
"Phillip Otto"
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]
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----- 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]
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----- 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]
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