MGMA Urges CMS to Ensure Continued Claims Payment

ENGLEWOOD, Colo. -- "Like medical group practices

throughout the country, we struggle with limited resources to deal with

the magnitude, complexity and costs of the Health Insurance Portability

and Accountability Act (HIPAA) implementation," said Cathy Treadway,

FACMPE, administrator at The Woman's Clinic, Boise, Idaho, as she

testified today on behalf of the Medical Group Management Association

(MGMA) before a hearing of the Senate Special Committee on Aging. "I am

very concerned that without some specific actions by the government,

cash flow to practices will be disrupted after October 16," said

Treadway.

Treadway is the administrator of a nine-physician, 65-employee

single-specialty obstetrics/gynecology practice, a member of MGMA and a

fellow in the American College of Medical Practice Executives (ACMPE).

Treadway described difficulties to members of the committee that both

she and other MGMA members are experiencing as they implement the HIPAA

privacy and the electronic transactions and code sets rule.

Within the testimony, MGMA offered a series of recommendations to

overcome the hurdles practices face as they continue to implement the

HIPAA transactions and code sets rule. Specifically, MGMA believes that

the Centers for Medicare and Medicaid Services (CMS) should instruct its

Medicare intermediaries to continue processing "legacy" claims after the

deadline. In addition, CMS should: explicitly permit claim data

flexibility; encourage heath plans to release their payment

contingencies; and request that health plans report data content

deficiencies to providers.

William F. Jessee, MD, FACMPE, president and CEO of MGMA, commended

Chairman Craig for convening this hearing to examine the difficulties

and costs the health care community faces with HIPAA implementation.

"We are pleased that the Senate Special Aging Committee is taking a

leading role in examining this area of concern," said Jessee. "We are

hopeful that the administration, with the help of Congress, will take

the necessary steps to avoid potential interruptions in payments to

practices and the delivery of care."

The MGMA, founded in 1926, is the nation's principal voice for medical

group practice. MGMA's 19,000 members manage and lead more than 11,000

organizations in which more than 220,000 physicians practice.

Source: MGMA

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