Medicare Fee-For-Service (FFS) Policy Regarding 90 Day Discretionary Enforcement Period for Non-Compliant HIPAA Covered Entities
The Centers for Medicare and Medicaid Services (CMS) announced<https://www.cms.gov/ICD10/Downloads/CMSStatement5010EnforcementDiscretion111711.pdf> it would not initiate enforcement action with respect to any HIPAA covered entity that is non-compliant with Version 5010, NCPDP, NCPDP D.0 and 3.0 standards until 90 days after the upcoming January 1, 2012 compliance date. Although compliance will not be enforced for Version 5010 until April 1, 2012, it is important to continue to take the necessary steps to complete your transition to Version 5010 as soon as possible. What the 90 Day Discretionary Enforcement Period Means For Medicare Fee-For-Service Medicare FFS has experienced significant increases in 5010 production transactions during the last few months. However, there are many submitters that have tested but not taken the step to move into production for 5010 and D.0. In addition, there are many submitters that have not yet initiated testing with their Medicare Administrative Contractor (MAC). Therefore, to ensure that submitters and receivers continue to make progress, Medicare FFS is planning to take the following steps for submitters and receivers of Medicare Part B and Durable Medical Equipment (DME) transactions: * In December 2011, submitters and receivers that have tested and been approved for 5010/D.0 will be notified that they have 30 days to cutover to the 5010/D.0 versions. * Submitters and receivers that have not yet tested will be notified in December 2011 that they must submit their transition plans and timelines to their MAC within 30 days. * MACs will notify the submitters and receivers, but submitters/receivers have the responsibility to notify the providers they service. Note: Submitters and receivers of Medicare Part A transactions will follow the same action plan starting 30 days after Part B and DME. Keep Up to Date on Version 5010 and ICD-10. Please visit the CMS ICD-10 website<http://www.cms.gov/ICD10> for the latest news and resources, and to download and share the implementation widget<http://www.browserspring.com/widgets/cms2/iframe.html> today! ------------------------------------------------- Each Office Visit is an Opportunity. Medicare patients give many reasons for not getting their annual flu vaccination, but the fact is that flu seasons are unpredictable and can be severe. Each year, it is estimated that 90 percent of seasonal flu-related deaths and more than 60 percent of seasonal flu-related hospitalizations occur in people 65 years and older. Please talk with your Medicare patients about the importance of getting their annual flu vaccination. And remember, vaccination is important for healthcare workers too, who may spread the flu to high risk patients. Don't forget to immunize yourself and your staff. Protect your patients. Protect your family. Protect yourself. Get the Flu Vaccine-Not the Flu. Remember - The flu vaccine plus its administration are covered Part B benefits. CMS has posted the 2011-2012 seasonal flu vaccine payment limits at http://www.CMS.gov/McrPartBDrugAvgSalesPrice/10_VaccinesPricing.asp. Note that the flu vaccine is NOT a Part D-covered drug. For more information on coverage and billing of the flu vaccine and its administration, as well as related educational provider resources, visit http://www.CMS.gov/MLNProducts/35_PreventiveServices.asp and http://www.cms.gov/immunizations. ------------------------------------------------------ Note: If you have problems accessing any hyperlink in this message, please copy and paste the URL into your Internet browser. If you know someone who would like to subscribe to a Medicare Fee-For-Service (FFS) provider listserv, go to (http://www.cms.gov/prospmedicarefeesvcpmtgen/downloads/Provider_Listservs.pdf). If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/wa.exe?INDEX) to unsubscribe or to leave the appropriate listserv. Please DO NOT respond to this email. This email is a service of CMS and routed through an electronic mail server to communicate Medicare policy and operational changes and/or updates. Responses to this email are not routed to CMS personnel. Inquiries may be sent by going to (http://www.cms.gov/ContactCMS). Thank you.
