In The News: 5010 Implementation Update, AZ Medicaid Cuts Approved, Berwick Replacement Nominated

CMS Keeps Deadline, Announces 90-Day Grace Period for 5010 Implementation — CMS recently announced that it will keep in place a January 1, 2012 deadline for medical providers to update their computer systems to the 5010 standards. The 5010 standards apply to how computers exchange health care billing data with each other.  “Covered entities” under HIPAA including – clearinghouses, physicians, hospitals, and insurers – must switch their billing software from the current set of HIPAA transaction standards (Version 4010) to Version 5010 by January 1, 2012. However, CMS announced a 90-day grace period for providers to continue updating their systems where CMS will not begin enforcing penalties until April 1, 2012. MORE 

CMS Approves Additional Arizona Medicaid Rate Cut — Arizona Medicaid providers will be reimbursed 5% less retroactive to October 1st under a plan submitted by Gov. Jan Brewer and recently approved by CMS.  The cuts are in addition to a separate 5% cut in April 2011 and a rate freeze beginning in 2007.  The end result is Arizona Medicaid providers will now be paid just 70% of the typical Medicaid reimbursement payment.  States across the country are experiencing budgetary shortfalls due to decreasing state revenues, and increased Federal funding from the 2009 stimulus bill come to an end. MORE

**UPDATE Arizona hospital providers have filed a lawsuit challenging the across-the-board cuts to Medicaid providers.  Read more about the suit HERE

Berwick Resigns, Obama Taps Tavenner to Lead CMS — Don Berwick,  the oftentimes controversial Director of the Centers for Medicare and Medicaid Services, resigned effective December 2nd last week. President Obama has nominated Marilyn Tavenner, Berwick’s deputy, as his choice to lead the agency moving forward.  Tavenner began her career as a nurse at a Virginia hospital before slowly making her way to become chief executive of the largest hospital group in the state.  Previously serving as a chief deputy to Berwick, Tavenner’s blend of public and private health care experiece seems to lend itself to her potential new responsibilities as Director of CMS. Confirmation hearings are beginning to take shape with Republicans questioning Tavenner’s previous responsibilities related to implementing many of the provisions created as part of the Affordable Care Act over the last 18 months.  MORE 

Deficit Super Committee Deadlocks

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One Response to In The News: 5010 Implementation Update, AZ Medicaid Cuts Approved, Berwick Replacement Nominated

  1. Pingback: CMS Announces 5010 Enforcement Delay, Final Rule on Medicaid Expansion | OPGA Blog

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