Electronic claims rule may be postponed

Doctors' offices, hospitals and health plans would have an extra year to comply with the new standards -- if they do the paperwork.

By Amy Snow Landa, AMNews staff. Dec. 24/31, 2001.

Washington -- Congress appears likely to approve legislation by the end of the year that would postpone the deadline for physicians' offices and other health care entities to comply with new standards for electronic data transactions.

Regulations issued by the Dept. of Health and Human Services require that most health care entities adopt common standards for the electronic transmission of administrative data, such as claims, health plan eligibility and premium payment, by October 2002.

But both the House and Senate recently approved legislation that would extend the deadline by one year -- to October 2003 -- to give physicians' offices, hospitals, health plans and health care clearinghouses more time to get ready for the new electronic transactions standards.

The new standards implement provisions of the 1996 Health Insurance Portability and Accountability Act that were designed to increase the health system's efficiency, reduce administrative burdens, and prevent fraud and abuse.

Although the House and Senate approved similar measures to delay the compliance deadline by one year, the two bills contain differences that, at press time, still required reconciliation before a final agreement could be sent to President Bush for his signature.

The Senate measure grants health care entities the one-year extension automatically, but the House version provides a one-year delay only to those entities that submit a plan to HHS by October 2002 detailing how they intend to achieve compliance by the following year. [...]