[ Friday, September 26, 2003 ]


Yesterday, CMS held a call-in town hall teleconference where they spoke about the current state of the HIPAA universe. I was out part of the day, unfortunately, and working on a financing for a surgery center, so I didn't get to listen in. But the inestimable Alan S. Goldberg was, and posted the following to the American Health Lawyers Association Health Information Technology (HIT) listserv:

"CMS: Trying to encourage compliance instead of primarily processing complaints. Not likely that plans implementing contingency plans will file complaints vs. providers who cannot do TCS; instead, plans likely will give a couple of months notice before cut off and thereupon only compliant claims to be accepted. Plans implementing a contingency need to do provider outreach and push testing and be in good faith with contingency. Will continue to meet with major groups representing health plans and providers; will work with them regarding working together. Payors are not required to have contingency plans; if partners are ready, might not have one. Health plans must be ready to accept compliant transactions on Oct. 16, 2003. Providers can file complaints vs. plans that will not accept TCS on Oct. 16, 2003 (eg., such as if provider can only use TCS and can't use something else). If provider bears extra costs to use older format because plan is not ready, CMS cannot require non-compliant plans to reimburse providers for out of pocket costs of postponding TCS. When CMS is about ready to turn off contingency, CMS will provide ample advance notice. Wed. Oct. 8, 2003 is next Roundtable. 2,600 folks listening today ."

Jeff [9:06 AM]

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