Medicare Compliance & Reimbursement

Medicare Part A providers are generally confident that they'll be ready for the Oct. 16 zero hour for the Health Insurance Portability and Accountability Act electronic data transaction standards. According to the HHS Office of Inspector General, 96 percent of Part A providers "have moderate to high expectations" that they'll be compliant by the deadline. Moreover, while less than 30 percent have begun testing, 90 percent have developed a testing strategy, according to "HIPAA Readiness: Administrative Simplification for Medicare Part A Providers" (OEI-09-02-00421). Indeed, the big worry for Part A providers isn't their own compliance readiness - it's that of their business partners. Payors' readiness - including Medicare contractors and/or the Centers for Medicare & Medicaid Services - was a frequently reported barrier to compliance, the OIG says. To see the report, go to http://oig.hhs.gov/oei/reports/oei-09-02-00421.pdf. Lesson Learned: Even HIPAA-savvy health care providers should be ready for the possibility that their payors won't be as up to speed on transaction and code set compliance as they are.