Meaningful use & 5010 claims

HHS delays Stage 2 of Meaningful Use until 2014

The Department of Health and Human Services (HHS) announced that Stage 2 of the Medicare EHR incentive program (Meaningful Use) would be delayed until 2014. Under the current requirements, eligible professionals (EPs) that begin participating in the meaningful use incentive program this year would have to meet new and more challenging standards for the program in 2013. If an EP did not participate in the meaningful use program until 2012, they could wait to meet these new standards until 2014 and still be eligible for the same incentive payment. In an effort to encourage faster adoption, EPs are permitted to adopt an EHR this year, without meeting the new standards until 2014.


5010 claims deadline still Jan. 1 despite enforcement delay

The compliance date to replace the current Version 4010 with Version 5010 of the standards for electronic claims and other HIPAA transactions is Sunday, Jan. 1. Although the Centers for Medicare & Medicaid Services recently issued a 90-day enforcement delay, practices are still required to comply with the Jan. 1 date to send claims using the new standard. In its announcement, CMS indicated that it would exercise its enforcement discretion with respect to any HIPAA covered entity (provider, clearinghouse or health plan) that had a complaint filed against it for violation of compliance with Version 5010 standards.

Note that some health plans have announced that they will stop accepting claims submitted in Version 4010 on Friday, Dec. 31.

Practices that do not make the transition to Version 5010 risk cash flow disruption. If you have not heard from your practice management system or billing system software vendor, billing service, clearinghouse, or health plans regarding the Version 5010 transition, contact them to discuss their Version 5010 readiness plan.