CMS extends HIPAA deadline

Friday, October 31, 2003

WASHNGTON - Many small HME companies breathed a collective sigh of relief when, just three weeks before the Oct. 16 deadline for HIPAA electronic transaction and code set standards, CMS announced it would accept noncompliant electronic transactions after the deadline.

CMS decided to go ahead with the extension to ensure that claims would be processed from the thousands of providers who were having trouble meeting the new HIPAA standards. Statistics showing unacceptably low numbers of compliant claims being submitted prompted the agency to act.

The delay is good for HME providers.

“The industry is notorious for having people wait for the last minute to get into compliance, whether be it with fraud and abuse prevention or HIPAA,” said attorney Corrine Parver.

Additionally, problems with technology have slowed progress, said Parver. IT departments were having difficulty implementing the technology and were not confident that the programs would accurately communicate the standard transaction form.

“It is a tremendous relief because it is always worrisome to us when they do some sort of software change requirement like this, because inevitably there are some glitches, and we just can’t afford to let our cash flow be interrupted for long,” said Scott Walker co-owner of Alliance Medical in Granbury, Texas.

CMS also encouraged private, non-Medicare insurers to follow suit and grant a deadline extension. Blue Cross and Blue Shield of Michigan announced it also would make provisions to allow additional time.

“It wouldn’t be either surprising or unusual to have the private side go along with this because on so many other issues, like coverage determinations and reimbursement levels, the privates follow what Medicare does,” Parver said.

A specific date when Medicare would stop processing noncompliant claims was not set, but officials at CMS said providers should make “reasonable and diligent” efforts to meet the standards. CMS will monitor the percentages of compliant claims and make the decision to end the extension when progress has been made.