----- Original Message -----
From: "Kirsten Knutson" <KKnutson@...>
To: <HHS_CMS_PRESS@...>
Sent: Thursday, September 11, 2003 11:58 AM
Subject: CMS News Release: STATEMENT OF LESLIE V. NORWALK, ACTING
DEPUTY
ADMINISTRATOR, ON HIPAA


> Centers for Medicare & Medicaid Services
> Public Affairs Office
>
> MEDICARE NEWS
> FOR IMMEDIATE RELEASE
> September 11, 2003
> Contact: CMS Public Affairs Office, (202) 690-6145
>
> STATEMENT OF LESLIE V. NORWALK,
> ACTING DEPUTY ADMINISTRATOR,
> CENTERS FOR MEDICARE & MEDICAID SERVICES
> ON CONTINGENCY PLAN AND COMPLIANCE WITH THE HIPAA TRANSACTION AND
CODE
> SETS ON OCTOBER 16, 2003
>
> October 16 is just 35 days away, and all covered entities should be
> actively working with their trading partners on outreach, testing
and
> contingency planning.
> This deadline is the law and we all have to deal with it. It's not
> something that can be ignored or brushed aside.
>
> Our real challenge now is to help all the entities covered by HIPAA
to
> become compliant as quickly as possible and to plan for the problems
> that may arise after October 16.
>
> As we face the challenge of HIPAA, we should all keep in mind that
in
> the long run HIPAA is going to make things a lot better for
everybody.
> For one thing, it is expected to result in significant savings for
the
> health care industry – and the taxpayer --- over the first ten
years,
> above and beyond whatever start-up costs folks are facing now.
>
> Once the electronic simplification provisions of HIPAA are
implemented,
> processing and paying claims, and exchanging all sorts of medical
> information will be far easier than it is now. Doctors, hospitals,
> insurance plans and others will be able to communicate with each
other
> with the same ease of someone from New York traveling in California
> doing business with his bank back home by going to an ATM that
speaks
> the same language as all the other ATMs. That's a goal worth all
our
> efforts now.
>
> As the largest HIPAA covered entity, we at Medicare do understand
the
> difficulties in becoming compliant first hand. That's why we've
> been working hard to help our HIPAA partners become compliant. We
have
> held conferences, town hall meetings, and roundtables, provided a
> variety of outreach materials, conducted a national ad campaign,
> provided e-mail technical assistance and a toll-free telephone
helpline,
> among many other efforts.
>
> Now we are working on the possibility of Medicare implementing a
> contingency plan. And I urge other health plans to announce their
> contingency plans as soon as possible to
> allow their trading partners enough time to make any needed changes
to
> their business operations to make sure any disruptions in their
health
> care operations are minimal.
>
> On July 24, 2003, the Department of Health and Human Services (HHS)
> issued guidance regarding the enforcement of the HIPAA transactions
and
> code set standards after October 16, 2003. Industry support remains
> strong for the HIPAA transaction and code set standards. However,
we
> are not confident that providers are ready or that they have enough
time
> for adequate testing.
>
> HHS recognizes that transactions often require the participation of
two
> covered entities and that noncompliance by one covered entity may
put
> the second covered entity in a difficult position. The Departmental
> guidance clarified that covered entities, which made a good faith
effort
> to comply with HIPAA transaction and code set standards, may
implement
> contingencies to maintain operations and cash flow.
>
> While Medicare will be able to accept and process HIPAA compliant
> transactions, the Centers for Medicare & Medicaid Services (CMS) is
> actively assessing the readiness of its trading partners to make
sure
> that cash flow to Medicare fee-for-service providers will not be
> disrupted. Last week, CMS shared Medicare's fee-for-service
> contingency plan with the provider community so that they could be
> prepared to work with the Agency should CMS deploy it.
>
> Medicare's contingency plan is to continue to accept and process
> transactions that are submitted in legacy formats while their
trading
> partners work through issues related to implementing the HIPAA
> standards. Medicare will make a decision on whether to deploy this
> contingency no later than September 25, 2003.
>
> In reviewing its trading partner readiness and whether to deploy its
> contingency, Medicare will assess the number of Medicare submitters
who
> are testing and in production with our contractors. If Medicare
deploys
> this contingency, it will be for all Medicare fee-for-service
> contractors. Medicare will continue its active outreach and testing
> efforts to bring its trading partner community into compliance in
the
> days before and, if necessary, after October 16, 2003.
>
> # # #
>