HIPAA 5010 6-Month Contingency Plan

With various statements and difficulties in implementing the HIPAA Version 5010, the Medical Group Management Association or MGMA has requested for a HIPAA 5010 6-month contingency plan. These proposed health plans should accommodate HIPAA 4010 transactions and be able to judicially settle HIPAA 5010 claims that do not have the necessary data. Susan Turney, MD, MS, FACP, FACMPE, MGMA-ACMPE president and CEO said, "Our main concern is that the failure to implement Version 5010 by the compliance date will impact payment to practices for the services they provide. We oppose requiring the submission of a transition plan and timeline as a needless bureaucratic exercise that adds to the workload of the providers who have to produce them and the government employees who have to review them. HHS should immediately allow physician practices to continue submitting Version 4010 transactions”.

Only a few healthcare providers were ready for the Version 5010 and the MGMA conducted a survey of 140 MGMA members according to the Health Data Management. The results showed that only 32% stated that they had completed internal testing and that the practice management system software had been upgraded to the HIPAA Version 5010 standards. Another 32% declared that they had completed testing with their Medicare contractors. 25% of the providers said that their software had not been scheduled or tested. 17.9% had finished testing their Medicaid plans. 22% declared that they had not scheduled testing with their Medicare contractors. 30% and more providers had not scheduled testing and that Medicaid plans were not accepting test claims. 23.5% admitted that they had not planned their testing with any important commercial health plans. 79% declared that their testing schedule was incomplete with commercial health plans. 23% of the providers stated that their contingency plans would be based on paper claims.13.9% said that they had completely finished implementing HIPAA 5010. Susan Turney, MD, MS, FACP, FACMPE, MGMA-ACMPE president and CEO said, "The serious challenges in meeting the Version 5010 mandate and the need for a comprehensive contingency plan from HHS call in to question the ability of the industry to transition to ICD-10 by the Oct. 13, (sic) 2013, compliance deadline".

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