The Medical Group Management Association is urging CMS to delay the Jan. 1, 2012, compliance date for new HIPAA 5010 electronic transaction standards by six months, Health Data Management reports (Goedert, Health Data Management, 12/20).
Background
HIPAA 5010 standards regulate the transmission of certain health care transactions among hospitals, physician practices, health plans and claims clearinghouses.
Converting to the HIPAA 5010 standards is seen as key to the larger switch from the ICD-9 clinical coding system to the ICD-10 system.
Last month, CMS announced that it would wait until March 31, 2012, to begin enforcing compliance with HIPAA 5010 standards. However, CMS noted that the compliance date would remain Jan. 1 (iHealthBeat, 12/20).
'Contingency Plan'
MGMA cited a new survey of its members that found that a significant number of stakeholders are not ready to handle 5010 transaction sets (Health Data Management, 12/20).
According to the survey:
- 32% of respondents said their organization's practice management system has been properly upgraded and that internal testing is complete (Conn, Modern Healthcare, 12/20);
- 32% said testing is complete with Medicare contractors; and
- 18% have finished testing with Medicaid plans.
The survey also found that 79% of respondents have not yet completed testing with all commercial health plans (Health Data Management, 12/20).
MGMA is calling on CMS to issue a "contingency plan" that would allow health plans to continue to accept HIPAA 4010 transactions and adjudicate any 5010 claims that lack any necessary data. MGMA said the contingency plan should last at least six months.
MGMA President and CEO Susan Turney said, "Our main concern is that failure to implement Version 5010 by the compliance date will impact payment to practices for the services they provide" (Godt, CMIO, 12/20).
Turney added, "We are very concerned that at least seven state Medicaid plans, including California, have announced that they will be unable to meet the mandated Jan. 1 deadline" (Modern Healthcare, 12/20).