Industry News: Other Healthcare News

The Medical Group Management Association (MGMA) is calling on the Department of Health and Human Services (HHS) to issue a HIPAA 5010 contingency plan permitting health plans to adjudicate claims that may not have all the required data.

MGMA’s research suggests that critical coordination among many practices and their trading partners has not yet occurred. Practices that do not successfully implement Version 5010 by the Jan. 1, 2012, compliance date face possible disruption in cash flow, say experts.

The BlueCard Program links participating healthcare providers and the independent Blue Cross and Blue Shield Plans across the country, as well as more than 200 countries and territories, through a single electronic network for claims processing and reimbursement.

Labs have submitted all Blue Cross and Blue Shield claims to their local service area plan and the local plan moves the claim to the BlueCard network for processing.

As the deadline for HIPAA version 5010 looms around the corner on January 1, 2012, demand for information on ICD-10 implementation and risk mitigation continues to escalate. Healthcare Information and Management Systems Society (HIMSS), along with 29 plus participating organizations consisting of associations, providers, health plans, vendors, clearing houses, financial institutions, work force solutions groups and a host of leading industry stakeholders, launched the ICD-10 PlayBook on May 25.

Washington is the latest state to enact direct billing legislation for anatomic pathology (AP) services. The legislation, signed into law April 20, will ensure that patients are billed for AP service only by the physician who performs or supervises the service. Similar legislation is pending in Indiana, and if approved, Indiana would become the 18th state with a direct billing law.

Centers for Medicare and Medicaid Services (CMS), has rescinded its original directive requiring physician signatures for all Medicare orders of clinical diagnostic laboratory services paid on the CLFS that would have become effective on 4/1/2011.

If you wish to monitor physician compliance with a signature on an order for record keeping purposes, you may still use the Signature tracking functionality within the XIFIN system.

Most pathologists and clinical laboratory managers are not aware that implementation of global location numbers (GLNs) will occur in just a few months. Every healthcare provider in the United States and many other nations will get a unique GLN.

Pathologists and clinical laboratory managers will soon have a comprehensive registry of genetic tests that they can consult as needed. The National Institutes of Health (NIH) is creating a single public registry with detailed information about both genetic test providers and the 1,600+ genetic tests these providers offer.

The NIH believes the genetic test registry will bring greater transparency to the field. It hopes that the registry creates increased information-sharing about the different genetic tests which are available. Participation in the registry will be voluntary.

A recently launched federal website, www.healthcare.gov, provides consumers with information about private and public health coverage options, tailored specifically for their needs in a single, easy-to-use tool. In addition, the website will be a one-stop-shop for information about the implementation of the Affordable Care Act and other health care resources.