The Centers for Medicare and Medicaid Services
(CMS) announced November 17 that it will hold off for 90 days on
enforcement actions on non-compliance with the HIPAA upgrades
that are effective January 1, 2012. As of January 1, HIPAA-covered
entities are to be using the Accredited Standards Committee (ASC)
X12 Version 5010 transactions or National Council for
Prescription Drug Programs (NCPDP) Version D.0. The CMS
announcement means that, in its role of overseeing the HIPAA
transactions, CMS will not begin to level fines or take other
action until March 31, 2012—three months after the compliance
date.
The CMS announcement does not prohibit health
plans from denying transactions that are not in the new version.
However, the electronic data interchange (EDI) structure does
allow receivers to accept an older version (for example, a
partner up to speed on 5010 can accept 4010). CMS did not
indicate if it would reject version 4010 claims (X12-837). CMS
also did not address the problems that providers who are not
ready for version 5010 will have in accepting 5010 remittance
and payment transactions (X12-835).
While the potential exists for the industry to
use both versions 4010 and 5010, this solution will not be
possible for the ICD-10-CM/PCS conversion in 2013, and CMS has
been clear that this change will not affect the ICD-10
compliance deadline. To review the CMS press release,
click here.
AHIMA calls for national dialogue between all
stakeholders to address the recommendations made in the
Institute of Medicine’s (IOM) report, “Health IT and Patient
Safety: Building Better Systems for Safer Care.” Read the
complete statement
here. As a result of AHIMA’s timely response to the IOM
report, the association was well represented in the media on
this important issue. A couple examples include AHIMA’s Practice
Resources Director Lou Ann Wiedemann, MS, RHIA, FAHIMA, CPEHR,
interview with the
Wall Street Journal; and AHIMA’s director of Practice
Leadership Michelle Dougherty, MA, RHIA, CHP, commented on the
issue in
SearchHealthIT.
Looking for more information on the Freedom of
Information Act? Check out the
Practice Brief in the Body of Knowledge on the AHIMA Web
site! The brief is a review and comparison of the Homeland
Security, Patriot, and Freedom of Information Acts. It also
includes information about the mandatory reporting of health
information and an overview of syndromic reporting (a new form
of mandatory reporting). Be sure to also read the tips on how to
incorporate these acts into the workplace. This practice brief
provides a great refresher on protecting patient privacy, so
check it out today!
The Measure Applications Partnership (MAP) is a
public-private partnership created for the purpose of providing
input to the Department of Health and Human Services (HHS) on
the selection of performance measures for public reporting and
performance-based programs. Two MAP draft reports are now
available for public comment:
The
Clinician Performance Measurement Coordination Strategy
draft report aims to enhance alignment across federal programs
focusing on aligning measures and data sources, characterizing
an ideal measure set, defining data platform principles, and
determining a pathway for improving measure application. The
clinician coordination strategy also features a draft version of
the MAP measure selection criteria that will be used to assess
fitness of a measure set for use in a specific program.
The
Coordination Strategy for Healthcare-Acquired Conditions and
Readmissions Across Public and Private Payers draft report
identifies three focus areas for aligning public and private
efforts to reduce healthcare-acquired conditions and
readmissions: measures, data, and specific coordination
strategies. Comments are due by Monday, September 12, at
6 pm ET. AHIMA is calling for volunteers to
participate in the review and comment of the reports. If you are
interested, please contact AHIMA’s director of practice
leadership,
Crystal Kallem, or call (312) 233-1537.
AHIMA recently responded to a proposed
regulation issued by the Centers for Medicare and Medicaid
Services (CMS) [76FR33566] implementing new statutory
requirements regarding the release and use of standardized
extracts of Medicare claims data to measure the performance of
providers and suppliers in ways that protect patient privacy.
This rule explains how entities can become qualified by CMS to
receive standardized extracts of claims data under Medicare
Parts A, B, and D for the purpose of evaluation of the
performance of providers of services and suppliers.
