Family physicians filing Medicare claims take note: Beginning Oct. 1, CMS won't process Medicare claims unless they are in compliance with the Health Insurance Portability and Accountability Act.
On that date, CMS formally ends a contingency plan announced Oct. 16, 2003, to give physicians and other covered entities more time to comply with the HIPAA regulation.
"Ending the contingency plan for noncompliant Medicare claims makes sense," said CMS Administrator Mark McClellan, M.D., Ph.D., in a CMS press release. "We are firmly committed to an interoperable electronic health care system, and the close-to-100-percent compliance with HIPAA standards for claims shows that the health care industry shares this commitment."
The announcement likely will affect only a small number of family physicians. CMS reports that as of May, the rate of noncompliant claims submitted by physicians had dropped to just 0.45 percent. By comparison, 1.45 percent of hospital claims and 1.72 of clinical laboratory claims were noncompliant.
Some background: The law required all payers -- public and private -- to conduct HIPAA-compliant transactions no later than Oct. 16, 2003. However, only 31 percent of Medicare claims were HIPAA-compliant at the time; other payers had even lower numbers. CMS announced the contingency plan as a stopgap measure to give its trading partners, including physicians, more time to comply with the regulation.
If you need help making your claims HIPAA-compliant, check out the Academy's online HIPAA resources.
