Home Health & Hospice Week

Delay to transactions rule compliance could give providers a much-needed breather.

Are you worried that, despite your best efforts, you won't be ready when the Health Insurance Portability and Accountability Act transactions rule zero-hour arrives Oct. 16? If so, you're not alone - and you may get a break from the Centers for Medicare & Medicaid Services.

CMS has revealed Medicare is considering deploying a contingency plan for HIPAA-covered entities that aren't ready by the deadline. "Medicare's contingency would be to accept and send transactions in legacy formats - in addition to HIPAA compliant transactions - while trading partners work through issues related to implementing the HIPAA standards," the agency says in an update to the HIPAA-frequently asked questions section of its Web page.

CMS will make the decision about whether to deploy the contingency plan by Sept. 25. An ongoing assessment of "the readiness of our trading partner community including the number of Medicare submitters who are testing and in production with our partners" will determine whether CMS will implement the contingency plan, the agency says.

Meanwhile, providers want the same kind of information from other, non-government payors. In a Sept. 12 letter to the Health Insurance Association of America, the Association of American Health Plans and other groups, a coalition of providers urges payors to announce their plans by the same date as Medicare.