The Medical Group Management Association is calling for a contingency plan of at least six months for the transition to the HIPAA 5010 transaction sets, which has a compliance date of Jan. 1, 2012.

Under the plan, health plans would continue to accept Version 4010 transactions and adjudicate 5010 transactions that lack all required data. The association, which regularly surveys members and has previously warned that physicians and much of the industry remain unprepared for 5010, says federal officials need to expand the current contingency plan. The Centers for Medicare and Medicaid Services in November announced a 90-day grace period for enforcement of 5010.

A new survey of 140 MGMA members completed on Dec. 16 finds a significant number of stakeholders remain not ready for 5010, according to the association. Only 32 percent of respondents report their practice management system has been upgraded and internal testing is complete. Another 32 percent said testing is complete with Medicare contractors, only 18 percent have finished testing with Medicaid plans and testing with commercial payers remains unfinished for 79 percent of respondents.

Twenty-three percent of MGMA survey respondents plan to revert to paper claims come January 1 to avoid cash flow problems. Further, the challenges in meeting the HIPAA 5010 deadline call into question the industry’s ability to meet the Oct. 1, 2013 deadline for migrating to the ICD-10 code sets, the association contends.

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