Min DeParle minces no words: PPS delayed
At the time this issue of Homecare Education Management was going to press, it seemed clear that the prospective payment system for home care definitely would be delayed because of the year 2000 computer problem. Nancy-Ann Min DeParle, administrator of the Baltimore-based Health Care Financing Administration, clarified her early comments on the delay in a speech to a House Ways & Means Health Subcommittee on July 16. In that speech, she made these comments:
· "The year 2000 especially affects Medicare because of our extensive reliance on multiple computer systems. More than 183 systems are used in administering the Medicare and Medi caid programs, and 98 of these are considered 'mission critical' for establishing beneficiary eligibility and making payments to providers, plans, and states. Medicare is the most automa ted health care payer in the country. We process nearly 1 billion claims each year, or about 1.7 million transactions each week. Fully 98% of inpatient hospital and other Medicare Part A claims are processed electronically, as are 85% of physician and other Medicare Part B claims."
· "The renovation process is complicated because each piece in the systems used by Medicare, its 60-plus claims processing contractors, interfaces with state Medicaid programs, and some 1.6 million providers must be thoroughly reviewed and renovated by those responsible for each particular system."
· "To fix only the Medicare systems, we must renovate 49 million lines of code. We must renovate all Medicare-specific software and work with new versions of vendor-supplied software, including operating systems that drive the hardware we use."
· "Because of this imperative, year 2000 work must take precedence over other projects that require systems changes, including, unfortunately, some Balanced Budget Act provisions."
· "If year 2000 system renovations are complet ed ahead of schedule, we will make every effort to put these provisions back on the original schedule. But at this time it appears that postponing some projects is necessary to focus resources and freeze systems so essential year 2000 work can be done, and thereby avoid complicating factors in the critical months right before and after the new year."
· "At present, Balanced Budget Act provisions whose implementation we believe must be postponed include prospective payment systems for outpatient hospital care and home health services; consolidated billing for physicians and other Medicare Part B services in nursing homes; and a new fee schedule for ambulance services."
· "These activities are being postponed because they involve complex systems changes and interactions with other systems at the very time such activity would interfere with critical year 2000 work. Our claims processing contractors concur with the decision to postpone these activities."
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