HIPAA 5010 Electronic Transaction Standards CMS Announces Version 5010 Enforcement Discretion Period


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Topic HIPAA 5010 Electronic Transaction Standards CMS Announces Version 5010 Enforcement Discretion Period
Background The Centers for Medicare & Medicaid Services' Office of E-Health Standards and Services (OESS), has announced that it would not initiate enforcement action with respect to any HIPAA covered entity non-compliant with the ASC X12 Version 5010 (Version 5010) standards until June 30, 2012. This extends a previous enforcement delay that was to be end March 31, 2012 (See the March 31 entry for details on the previous HIPAA 5010 Electronic Transactiion Standards Enforcement Discretion Period delay). Please note, January 1, 2012 remains the compliance date for implementation for these updated standards.
Regulating Body Centers for Medicare & Medical Services
Compliance Date 6/30/2012
Consequences All physicians must comply with the new 5010 standards on January 1, 2012. This notice means that fines may be assessed by the government after June 30, 2012.
Next Steps 1) Contact vendors to see if a 5010 upgrade is required for your practice management or electronic health record systems. 2) Check the 5010 Update pages for your clearinghouse, billing service and payers to see when they will be ready for testing. 3) Identify changes to data reporting requirements and modify your business procedures to capture that data. 4) When upgrades are complete, send test claims to each of your payers. 5) Budget for unanticipated cash flow interruptions.
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