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Nov 17 2011   2:16PM GMT

CMS offering 90-day HIPAA version 5010 compliance grace period

Beastwood Profile: Beastwood

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CMS
HIPAA version 5010
ICD-10 conversion

The Centers for Medicare and Medicaid Services (CMS) is offering health care providers a 90-day grace period for HIPAA version 5010 compliance.

Officially dubbed a “period of enforcement discretion,” the grace period means that CMS won’t penalize noncompliance with the new HIPAA version 5010 electronic submission transaction standards until March 31, 2012.

The compliance deadline remains Jan. 1, 2012 — 45 days from today. As of Jan. 1, transactions submitted using the current standard, HIPAA version 4010, will still be rejected — they just won’t be subject to penalty. According to CMS, any HIPAA covered entity subject to a rejected transaction “must produce evidence of either compliance or a good faith effort to become compliant with the new HIPAA standards during the 90-day period.”

Use of HIPAA version 5010 is seen as a precursor to ICD-10 implementation, which will occur in the United States on Oct. 1, 2013. A new transaction standard is necessary because HIPAA version 4010 does not support ICD-10 codes.

16  Comments on this Post

 
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  • SearchHealthIT
    #HIPAA #version5010 enforcement gets 90-day grace period; deadline still 1/1/2012 http://t.co/4FcNyImx
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  • Fortrex
    #HIPAA #version5010 enforcement gets 90-day grace period; deadline still 1/1/2012 http://t.co/4FcNyImx
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  • Rich Newbold
    #HIPAA #version5010 enforcement gets 90-day grace period; deadline still 1/1/2012 http://t.co/4FcNyImx
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  • Avalution Consulting
    #HIPAA #version5010 enforcement gets 90-day grace period; deadline still 1/1/2012 http://t.co/I1yDlBiI via @SearchHealthIT
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  • Jenny Laurello
    #CMS offering 90-day #HIPAA version #5010 compliance grace period http://t.co/L4FWZqNv #HealthIT #HITsm #hcsm
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  • TennesseeEHR
    #CMS offering 90-day #HIPAA version #5010 compliance grace period http://t.co/L4FWZqNv #HealthIT #HITsm #hcsm
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  • Informatic Tech
    #CMS offering 90-day #HIPAA version #5010 compliance grace period http://t.co/L4FWZqNv #HealthIT #HITsm #hcsm
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  • SBSSHC
    What is the soucre of this statement?- "transactions submitted using the current standard, HIPAA version 4010, will still be rejected — they just won’t be subject to penalty" Is this up to the payer to accept or reject 4010 or is it per the regulations that they cannot accept in 4010 on Jan 1?
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  • Beastwood
    That is per the regulations.
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  • Twitter
    I heard that the state of Michigan will refuse to accept files for 5010 compliance testing after a certain date in December, 2011. How is that possible if the deadline has been extended to March 31, 2012?
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  • Beastwood
    All the recent announcement means is that providers won't be penalized by CMS if they are unable to comply with 5010 before March 31, 2012. Providers still have to meet the Jan. 1, 2012 deadline for using HIPAA version 5010. That explains why Michigan and other states would not allow 5010 testing to continue beyond the end of this month -- theoretically, providers should be ready for it by then.
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  • Twitter
    But states don't always require base 5010 formats and require specific enhancements. If you start a new company next year and there is a need to begin submitting to a state that requires enhancements to the 5010 standard, how will you begin the process?
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  • Why Didn’t ICD-10 Implementation Bring Down Europe’s Health System? | The Health Care Blog
    [...] billing clearinghouse for its physician customers, and conducted extensive, government-mandated HIPAA 5010 testing for electronic transactions with a bevy of payers large and small in advance of this week’s [...]
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  • Why Didn’t ICD-10 Implementation Bring Down Europe’s Health System? | Health Care Jobs in Illinois
    [...] billing clearinghouse for itsphysician customers, and conducted extensive, government-mandated HIPAA 5010 testing for electronic transactions with a bevy of payers largeand small in advance of this week’s [...]
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  • Why Didn’t ICD-10 Implementation Bring Down Europe’s Health System? | Health Care Jobs In Connecticut
    [...] billing clearinghouse for itsphysician customers, and conducted extensive, government-mandated HIPAA 5010 testing for electronic transactions with a bevy of payers largeand small in advance of this week’s [...]
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  • rwhess
    What is the amount of the penalty that CMS can impose on a health plan for non compliance. Is there a set amount per transaction. Is this posted anywhere? Thanks! 
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