There is no rest for the IT-savvy physician leader.
Just two days after the April 14 privacy compliance deadline comes another critical date on the HIPAA calendar--one that has received relatively scant attention.
Healthcare entities that send and receive electronic claims data must begin testing their data transmission systems for compliance with the HIPAA rule governing transactions and code sets. Or so the law says.
Whether they will test them or not is another story.
In a survey taken during the first two weeks of January, just 43% of healthcare provider organizations said they would be ready to begin testing by the April 16 start date. An equal number said they would not be ready for seven to 10 months-leaving a razor-thin margin for error to meet the Oct. 16 compliance deadline, according to a quarterly poll by the Healthcare Information and Management Systems Society and Montgomery Village, Md.-based consulting firm Phoenix Health Systems.
But the hammer of government is not going to come down on those late with testing, according to the government. CMS, the agency charged with enforcement of the transaction portion of HIPAA administrative simplification regulations, is pushing "voluntary" compliance and conducting enforcement based on individual complaints.
At a March meeting of the Workgroup for Electronic Data Interchange-Strategic National Implementation Process, just outside Chicago, Lori Davis of the CMS Office of HIPAA Standards made it clear that CMS will not "shoot first and ask questions later."
Still, it is up to healthcare providers to make sure their transactions are in order, since software vendors have no legal responsibility to meet the HIPAA requirements.
"Just because an 835 (transaction for remittance advice) is accepted doesn't mean it's correct," says Jim Whicker, director of electronic data interchange in the accounts receivable division of Intermountain Health Care, Salt Lake City. Whicker tells of one Intermountain test of an engine meant to translate old codes into HIPAA-compliant form that created a claim based on a diagnosis that was "inconsistent with the patient's gender."
Skip McKinstry, Oklahoma City-based vice president for marketing and sales at Claredi, a transaction technology certification service in Kaysville, Utah, offers this bit of caution: "The fact that the vendor is certified does not mean that the provider is off the hook."