I have been trying to get information on how states' Medicaid programs are going to cross-walk from their current proprietary long term payment systems to their HIPAA compliant systems. The current HIPAA code sets and claim structure supports the Medicare long term care system just fine but not many of the states' systems are "fit" well in the codes and transaction segments.
Just as an example, I work for a software company that specializes in the post acute/long term care segment of healthcare. We have approximately 100 skilled nursing facilities in the state of California using our software. California has both proprietary long term care billing formats and code sets. We will need to design, develop, test, and deploy to these 100 facilities before the extended deadline. Here is the information which California has communicated via their website:
HIPAA Implementation Status
The events of September 11th, coupled with the steadily eroding economy that preceded it, have changed the State's business paradigm. This has necessitated re-evaluation of the business priorities of California. The State finds itself in an untenable financial situation, experiencing a $11-14 billion shortfall. The Governor's budget must now reflect how the government will address this shortfall. To achieve this, the Governor is proposing significant reductions in the budgets for education and health, as well as other services and programs.
Medi-Cal will continue to remediate its system and does plan to implement the HIPAA standards. The State's implementation plan to become compliant with HIPAA requirements is being evaluated at this time, due to the current funding situation. Specifics are not yet available. Once Medi-Cal's plan of action has been solidified, it will be communicated with the payer and the provider communities.
Even with The one year extension I don't see how the entire long term care segment will be able to meet the deadline. It appears that no communication in this segment is happening. Is anyone aware of work going on to help the long term care segment get ready for HIPAA? Is there a sub-group in WEDI-SNIP that is helping? Are the code set issues currently being addressed?
If my fears are true, and nothing is really happening in this healthcare segment, how would one go about getting the ball started?
Yours in HIPAA frustration,
Mike Garrett
Director of Product Management
Shared Healthcare Systems
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