CMS announces delay to HIPAA transaction standards deadline

The Centers for Medicare and Medicaid Services (CMS) recently announced plans to delay the deadline for implementation of the Health Insurance Portability and Accountability Act (HIPAA) 5010 regulations by 90 days.

The period of compliance enforcement discretion is intended to ease the pressure on healthcare providers facing challenges in complying with the regulations by the original January 1, 2012 deadline.

The HIPAA guidelines were originally signed into law in 1996, and require that insurance providers offer medical coverage for members who unexpectedly lose their jobs. Many healthcare providers file claims relating to HIPAA coverage electronically, and migration to the new 5010 code set of claim submission protocols has proven challenging for some facilities.

According to an official statement by the CMS, the decision was made based on feedback from the healthcare information management community that suggests many providers are not yet in a position to conform to the electronic submission guidelines, and that volumes of data submitted so far has been low across some industry sectors.

Information Week reports that a majority of physician groups have not yet been able to begin adequate testing of the new claims submission software. A recent survey by the Medical Group Management Association (MGMA) suggests that only 35 percent of healthcare providers polled had begun internal testing, and that 27 percent indicated they had not yet scheduled any tests.

“We’ve heard reports from members that even some of the larger vendors have not been able to upgrade the software in time to begin the testing process,” Robert Tennant, a senior adviser at MGMA, told the news source. “[The CMS has] listened to MGMA and others, they’ve seen the research, and they’ve come to the conclusion that practices, and potentially hospitals, may not be ready.”

Learn more about our admissions