Bulletin: August 10, 2005

Medicare to enforce claim format

By: , Compliance Officer

Medicare claims submitted electronically after October 1, 2005 must meet the standards required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Medicare contractors will continue to process incoming non-HIPAA until that date.

The Centers for Medicare & Medicaid Services (CMS) has stated that 99.5% of Medicare claims are HIPAA compliant so they have decided to end the contingency plan for claims. The CMS contingency plan continues for other electronic transactions, but CMS expects to end its plan for these other transactions in the near future.