HIPAA noncompliance starts to hurt

Nursing Homes, May, 2004 by Douglas J. Edwards

The Centers for Medicare and Medicaid Services (CMS) is reminding providers that it certainly pays to submit HIPAA-compliant claims. Effective July 1, Medicare payment for electronic claims that are not HIPAA-compliant will take 13 additional days. Medicare carriers and intermediaries will begin enforcing these rules on July 6 to claims received on or after July 1. Thus, for example, HIPAA-compliant claims received on July 1 can be paid as early as July 15 (under existing waiting period rules), while claims received on July 1 that are not HIPAA-compliant can be paid no earlier than July 28.

In short, the government's patience is wearing a tad thin. Medicare implemented this contingency plan when it discovered that only 33% of electronic claims were HIPAA-compliant as of October 16, 2003, the compliance deadline.

Meanwhile, answering a frequently asked HIPAA-related question, the Center for Medicaid and State Operations/Survey and Certification Group at CMS has issued a letter stating that the HIPAA Privacy Rule does not alter the statutory requirements for nursing homes to post survey results or for the government to make survey results available.