"We were very encouraged by Secretary Thompson's response," said Alan Mertz, President of ACLA and the chair of the coalition of providers. "He clearly understands the magnitude of the problem and wants to work with the provider and payer communities to fix it."
The rule, which will go into effect on October 16, 2003, requires all electronic health care transactions to meet new format and content specifications. Without an implementation plan and clear guidance, the rejection of the new claims could lead to disruption of payments to providers under Medicare, Medicaid and private sector health plans.
Despite substantial progress by both payers and providers, many payers have indicated they will not be prepared to accept the new format by October 16. Others are unable to test the format with providers, so providers won't know if their submissions will be accepted. In addition, the new format and content standards require information -- detailed demographic information on the patient, referring physician identifiers and diagnosis codes -- that providers do not currently collect and which is not required to pay claims.
The provider letter asked HHS to take several steps to prevent disruption in the system, including making it clear that for a reasonable period of time after October 16 that compliance with HIPAA requires only that claims be in the standard format and contain only the information required to pay them.
Members of the coalition include the American Clinical Laboratory Association, the American Health Care Association, the American Hospital Association, the American Medical Association, Premier, Inc. and VHA Inc.
