As the date for compliance with the HIPAA regulations on electronic transactions and code sets arrives today, CMS is sticking with a previously announced edict that it will no longer pay Medicare claims submitted on paper, except in limited circumstances.
In its monthly "open door" conference call with physicians Wednesday, CMS officials confirmed they have no immediate plans to change an interim final rule it issued in August. A 60-day public comment period on the rule closed Tuesday.
"The information is final and we are moving forward," a CMS representative said during the conference call, which originated from a Philadelphia auditorium during the annual the Medical Group Management Association national conference.
According to the rule, CMS will only accept electronic claims for Medicare services, effective today, although the agency last month said the claims do not necessarily have to be in HIPAA-standard format, at least for the short term.
CMS gave approval for healthcare entities to continue to use "legacy" code sets for an unspecified period of time after the deadline, as long as they are making good-faith efforts to reach full HIPAA compliance. Most large private payers have implemented their own contingency plans.
Under the Medicare claims rule, HHS reserves the right to grant waivers to Medicare providers facing specific "unusual circumstances": for dental claims; during an interruption in service to electronic claims submission mechanisms that is outside the control of the biller; or other, unspecified "extraordinary circumstances precluding submission of electronic claims."
The rule also reiterates previously listed exceptions to the HIPAA transaction rule for practices with fewer than 10 full-time-equivalent employees and in cases where no method exists for filing electronic claims.