GOVERNMENTCaution urged for small practices tempted to take HIPAA loopholePhysician groups are pressing CMS to allow doctors to ease into the electronic transaction rules.By Joel B. Finkelstein, amednews staff. Sept. 8, 2003. Washington -- A new rule exempting small practices from filing electronic claims to Medicare and from meeting federal electronic transaction standards has some experts worried that physicians will flood payers with paper claims. The result could be a massive slowdown in claims payment come the Oct. 16 deadline. The Centers for Medicare & Medicaid Services estimates that more than 70% of physician practices meet the size criterion for the exemption. The fear is that many of the small practices that now submit electronic claims would revert to paper claims to get out from under the rules because they are behind on compliance. The American Medical Association and a coalition of physician and insurer groups are asking CMS to adopt an interpretation of the Health Insurance Portability and Accountability Act that would allow practices to continue submitting noncompliant electronic claims while they upgrade systems to the new standard. However, given the current situation, experts are urging physicians to work toward compliance. "Without assurances from CMS that there will be a post-Oct. 16 grace period -- and regardless of [its] decision -- physician efforts to meet the HIPAA deadline for the transaction and code set standards should continue," said AMA Trustee Joseph M. Heyman, MD. CMS guidance released on July 24 stated that the priority will be to help physicians move toward compliance, rather than resorting initially to penalties or fines. [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2003 American Medical Association. All rights reserved.
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