- Education released for 5010, new HIPAA X12 transaction standards.
- Obama FY2011 budget allocations millions for Health IT.
- HME industry snubbed by HHS at Medicare fraud summit.
5010: Taking EDI to the Next Level
CMS has released two new HIPAA Version 5010 fact sheets, as well as two companion checklists, to assist providers in transitioning to 5010, the new version of the X12 standards for HIPAA transactions.
HIPAA Version 5010 implementation presents substantial changes in the content of data that providers submit with their claims, as well as data available to them in response to their electronic inquiries for eligibility or claims status. These new educational materials inform providers of these changes and how they need to plan for their implementation.
Though designed for Medicare, Fee-For-Service providers, CMS believes they may be of interest to all health care providers. Go to http://www.cms.hhs.gov/Versions5010andD0 and click on “Educational Resources” to view these new educational products.
FY2011 proposed budget supports Health IT
This week, President Barack Obama released a $3.8 trillion budget proposal that includes approximately $110 million to bolster health IT adoption and research activities. Most of the $900 billion proposed for the U.S. Department of Health and Human Services (HHS) would be earmarked for Medicaid and Medicare.
Obama’s budget figures are based on an optimistic assumption that national health care reform legislation will pass, causing a $150 billion federal deficit reduction over the next 10 years. A modest amount of the savings, about $78 million, would go to the Office of the National Coordinator for Health IT, a $17 million increase from FY 2010.
HHS said ONC would use the funds to lead federal health IT efforts and implement programs established under the 2009 federal economic stimulus package. $4 million would be used by ONC to:
- Evaluate consumer perspectives on electronic health tools;
- Prepare for possible adverse events resulting from electronic health data exchange; and
- Support state implementation of federal health IT grants.
Other Health IT Funds
In addition to the portion of HHS funds set aside for ONC, the administration’s budget proposal includes:
- $32 million for the Agency for Healthcare Research and Quality (AHRQ) to promote patient safety;
- $1.6 million for HHS’ Office for Civil Rights to recruit regional privacy advisers; and
- $1 million for HHS’ Office of the Assistant Secretary for Planning and Evaluation to evaluate electronic health record adoption and the economic factors affecting health IT.
- $286 million for comparative effectiveness research.
- $1.7 billion to combat medical identity theft and other types of medical fraud.
Criminals posing as healthcare providers beware
In addition to Health IT spending, the budget nearly doubles discretionary spending for Health Care Fraud and Abuse Control, from $311 million to $561 million.
HME Sector Snubbed by Health Care Summit Organizers
Speaking of Medicare fraud, Home medical equipment (HME) providers were outraged last week when their offer to help was rebuffed and a national summit on health care fraud went on without industry input. The summit was part of HEAT (the Health Care Fraud Prevention & Enforcement Action Team), a joint effort of Justice and HHS.
Held Jan. 28, the National Summit on Health Care Fraud was organized by the Department of Health and Human Services and Attorney General Eric Holder’s office and included government officials, prosecutors and investigators, state law enforcement, private sector health care plans, consumers and providers other than those in HME.
The snub from both HHS and CMS prompted the American Association for Homecare and the VGM Group in Waterloo, Iowa, to voice their objections to members of Congress, saying their exclusion was “an illustration of CMS’ incompetence and should not be repeated in future meetings.”
“We will make it clear in our conversations with the administration and with Congress that we expect to be at the table when future discussions occur,” said Michael Reinemer, vice president, communications and policy, for AAHomecare.
