New Health Care Standards to Save up to $6 Billion *
On August 24, HHS Secretary Kathleen Sebelius announced a final rule that will
save time and money for physicians and other health care providers by
establishing a unique health plan identifier (HPID). The rule is one of a
series of changes required by the Affordable Care Act to cut red tape in the
health care system and will save up to $6 billion over ten years.
Currently, when a health care provider bills a health plan, that plan may use a
wide range of different identifiers that do not have a standard format. As a
result, health care providers run into a number of time-consuming problems,
such as misrouting of transactions, rejection of transactions due to insurance
identification errors, and difficulty determining patient eligibility. The
change announced on August 24 will greatly simplify these processes.
The rule also makes final a one-year proposed delay – from October 1, 2013 to
October 1, 2014 – in the compliance date for use of new codes that classify
diseases and health problems. These code sets, known as the International
Classification of Diseases, 10th Edition diagnosis and procedure codes, or
ICD-10, will include codes for new procedures and diagnoses that improve the
quality of information available for quality improvement and payment purposes.
The rule announced is the fourth administrative simplification regulation
issued by HHS under the health reform law:
*
On July 8, 2011, HHS adopted operating rules for two electronic health care
transactions to make it easier for health care providers to determine whether a
patient is eligible for coverage and the status of a health care claim
submitted to a health insurer. The rules will save up to $12 billion over ten
years.
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On January 10, 2012, HHS adopted standards for the health care electronic funds
transfers (EFT) and remittance advice transaction between health plans and
health care providers. The standards will save up to $4.6 billion over ten
years.
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On August 10, 2012, HHS published an IFC that adopted operating rules for the
health care EFT and electronic remittance advice transaction. The operating
rules will save up to $4.5 billion over ten years.
More information:
*
Fact
sheet<http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4443&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=6&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date>
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Adoption of a Standard for a Unique Health Plan Identifier; Addition to the
National Provider Identifier Requirements; and a Change to the Compliance Date
for the International Classification of Diseases, 10th Edition (ICD-10-CM and
ICD-10-PCS) Medical Data Code Sets Final
Rule<http://www.ofr.gov/OFRUpload/OFRData/2012-21238_PI.pdf>
Full text of this excerpted CMS press
release<http://www.cms.gov/apps/media/press/release.asp?Counter=4444&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date>
(issued August 24).
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