Effort on track,’ says Anne-DeParle
HCFA says Medicare provider
payment updates on schedule
A Healthcare InfoTech Staff Report
Despite concerns that Y2K priorities might delay scheduled Medicare payment updates for doctors, hospitals and other providers in both FY and calendar year 2000, the Health Care Financing Administration (HCFA; Baltimore) said this week that payment updates will be made in October and mid-January as long as Year 2000 readiness efforts continue on track.
HCFA administrator Nancy Anne-DeParle said that the agency’s top priority until Jan. 1, 2000, "is to make sure that Medicare computer systems are Y2K-compliant so that Medicare beneficiaries’ care is uninterrupted and that providers’ claims are paid in a timely fashion. At the same time, HCFA wants to meet statutory deadlines for making routine payment updates for providers, and I’m pleased that we’re now on track to meet both goals."
Last summer, following the recommendation of its Y2K expert consultant, known as an independent verification and validation (IV&V) contractor, HCFA said that provider payment updates might be delayed to minimize computer system changes during final Y2K testing and monitoring. However, after reviewing the status of the renovation and testing of systems with its IV&V contractor, HCFA now is saying that progress made on Y2K preparations will allow provider payment updates will be timely.
"We’ve made excellent progress on Y2K readiness, and our success means we can make the provider payment updates without jeopardizing our systems," DeParle said.
To ensure that Medicare claims are paid promptly and accurately after Jan. 1, 2000, HCFA is requiring that all electronic claims be Y2K-compliant. As of April 16, almost 100% of Part B claims submitters and more than 90% of Part A claims submitters were filing Y2K-compliant claims with eight-digit date fields. HCFA is working with industry trade groups to bring the compliance rate to 100% for both Part A and B claims.
Throughout the summer and fall, HCFA said, contractors will continue to test and re-test their computer systems. Then, beginning in July, all HCFA systems will undergo an extensive re-certification process.
By law, Medicare payment updates for Part A providers including inpatient hospitals, skilled nursing facilities, home health agencies and hospices are supposed to occur on Oct. 1 of each year, while payment updates for physicians and other Part B providers and suppliers are supposed to occur on Jan. 1 of each year.
Because of the Y2K compliance status of contractor systems, HCFA said it is now expecting to make Part A payment updates on Oct. 1, 1999, but will attempt to minimize system disruptions by making no changes in ICD-9-CM codes (International Classification of Diseases, 9th Revision, Clinical Modification) for fiscal 2000.
The agency said it expects to make Part B payment updates on Jan. 17, 2000, but will apply the updates retroactively to all claims for services provided on or after Jan. 1. Also, all typical coding changes will occur on Jan. 17 for Part B services and will be retroactive to Jan. 1.
Providers can file claims as usual, but Medicare contractors will hold all claims with dates of service of Jan. 1 or later until Jan. 17 to make sure the year 2000 payment updates and any changes in beneficiary coinsurance and deductibles, which take effect Jan. 1, are installed and applied correctly.
By law, electronic claims must be held for at least 14 calendar days but no longer than 30 days before payment can be made. Therefore, holding claims between Jan. 1 and Jan. 17 should result only in minimal payment delays. Additionally, relatively few claims are typically submitted during early January, so the impact on physicians, hospitals and other providers should be negligible.
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