MGMA: HIPAA 5010 Preparedness Low, and It’s Time to Worry

A recent survey of 350 practice administrator members of the Medical Group Management Association finds high awareness of the January 2012 deadline for migrating to the HIPAA 5010 transaction sets but very low preparedness levels. Three quarters of respondents were fully or substantially aware of the deadline while less than 2 percent were not aware at all, MGMA noted in recent testimony before the National Committee on Vital and Health Statistics, a federal advisory body. Further,…


A recent survey of 350 practice administrator members of the Medical Group Management Association finds high awareness of the January 2012 deadline for migrating to the HIPAA 5010 transaction sets but very low preparedness levels.

Three quarters of respondents were fully or substantially aware of the deadline while less than 2 percent were not aware at all, MGMA noted in recent testimony before the National Committee on Vital and Health Statistics, a federal advisory body. Further, 85 percent of respondents said their practice has not analyzed how 5010 will affect operations.

Based on survey results, MGMA offered several recommendations to the Centers for Medicare and Medicaid Services to improve industry transition to 5010, including:

* Develop a contingency plan permitting health plans to accept claims that do not contain all required 5010 data content.

* Expand tracking of implementation status and educational outreach,

* Quickly disseminate results from the June 15 Medicare national testing day,

* Expand the August Medicare national day of testing, set another testing day in the fall, and encourage commercial plans and clearinghouses to participate,

* Leverage provider association meetings the rest of this year to outreach directly to audiences, and

* Publish a concise and easy-to-understand set of 4010-to-5010 changes.

In conclusion, MGMA is very worried that its members or the industry will be ready for HIPAA 5010 by January. "A significant number of physician practices continue to wait on their practice management system software vendor to install the appropriate upgrade or replacement," according to the testimony. "We are also concerned about the cost incurred by those practices that are required to pay for the upgrade or replacement. Finally, we are alarmed by the lack of communication from health plans regarding Version 5010 external testing."

The complete testimony including survey results is available here.

 

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