In October, CMS instituted a contingency plan to allow providers to submit non-standard Medicare forms when it appeared that the health care industry would not be ready for compliancy by the October 16 deadline. As a result, only 69% of electronic submissions are in standard HIPAA format.
Karen Trudel, acting director of the Office of HIPAA Standards, has not set a deadline as to when only standardized transactions will be accepted, but hopes to give ample warning when that is to take place. Although CMS has no direct authority over private entities under HIPAA it has suggested that groups use contingency plans during this interim and the industry is prepared to comply with the ruling. At this time the Medicare program is receiving only 69% in HIPAA standard transaction format according to BNA's Health Plan and Provider Report. Individual states have made their own decisions as to accept standard or legacy claims, with only 10 states currently requiring claims be submitted in standard format.
Standard acknowledgement and error reports could effectively make payer communications consistent, WEDI suggests. They further recommend a requirement for establishing an industry work group to determine the resolution of data issues with benefit transactions and setting implementation schedules for providers, payers and clearinghouses; and industry wide standardization of HIPAA benefit transactions.