How CMS' EHR incentive plan is working — and what the next steps are for your practice

When family physician Christopher Tashjian attested for Stage 1 of CMS' "meaningful use" program bright and early on April 18, 2011, most other practices hadn't even picked out an EHR.

By April 2012, as few as one in five providers had attested, according to CMS' count.

The purpose of the meaningful use program, and the stimulus dollars attached to it, was to digitize America's healthcare-recordkeeping system — creating a data-based boon, say proponents, for providers and public health advocates alike. But the program got off to a slow start, and questions have emerged about the efficacy of the program and its administration by the government.

Is the incentive program working as it was intended? Let’s look at the details — past, present, and future — to find out.

The EHR incentive: a look back

CMS published the final rule for its Medicare and Medicaid EHR incentive programs to the Federal Register on July 28, 2010. Enacted in the Health Information Technology for Economic and Clinical Health (HITECH) Act — part of the American Recovery and Reinvestment Act of 2009, aka the federal stimulus — the nearly 300-page rule outlines how "eligible professionals" (EP) and hospitals can qualify for incentive payments for demonstrating meaningful use of a certified EHR.

The first step in receiving the money (a maximum of $44,000 paid over the course of five years) is to attest that during a 90-day reporting period, providers used their EHR in a meaningful way by fulfilling 15 core requirements (such as maintaining an active medication-allergy list for more than 80 percent of patients), five out of 10 menu set objectives (such as implementing drug-formulary checks), and six clinical quality measures (such as adult weight screening and follow-up).

This represents just Stage 1 of the three-stage program. To receive the full financial incentive, CMS requires the completion of all three stages. (CMS has also outlined a separate program for providers who wish to qualify through Medicaid.

To help small practices, the government's Office of the National Coordinator for Health Information Technology (ONC), has so far awarded more than $720 million through 62 Regional Extension Centers. The RECs provide free and low-cost assistance to qualifying practices to ease their EHR transition and help them achieve meaningful use.

EHRs by the numbers

What does CMS have to show for all of this effort? The government's figures show it is now meeting its objectives, despite getting off to a slow start.

CMS finished 2011 well below its stated objectives of at least 40,000 meaningful users attesting via the Medicare program and 21,100 meaningful users via Medicaid. The actual numbers at the end of last year: 15,361 for Medicare and 15,439 for Medicaid. But the government says it has already closed the gap between its projections and the reality: As of May 31, 2012, 110,000 providers (roughly one out of five eligible for the program) have received some portion of the more than $5.7 billion paid out so far to hospitals and providers under one of the two programs, according to CMS. How did CMS go from about 30,000 meaningful users to more than 110,000 in only five months? It did not respond to our request for an explanation, but if its most-recent data are correct, then it is now on track to meet its goals of between 48,700 and 154,700 meaningful users under Medicare, and between 34,000 and 93,700 under Medicaid by the end of 2012.

If it meets its most ambitious objectives, about half of America's eligible providers will be meaningfully using an EHR by the end of the year.

 
Source from Physicians Practice.

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Basic Medical Terms Your Practice Staff Should Know

Get the most benefits at the least costs !

Last week, we talked about the difference and definitions of major insurance types in "Medical Insurance Primer for Practice Staff." A fellow blogger pointed out that many patients are also not aware of the differences between copay, co-insurance, and a deductible. Below are some additional terms for your staff to have that will easily explain these differences to your patients.

Allowed Amount: Amount of the billed charge the insurance company deems is payable by the plan.

(MORE: Medical Insurance Primer for Practice Staff)

 

Assignment of Benefits: The patient or guardian signs the Assignment of Benefits form so that the physician or medical provider will receive the insurance payment directly.

Authorization: Approval by the health plan if the physician wants to refer the patient to a specialist.

Bundling: Method by which the insurance company decides to combine payment for two or more medical services.

Capitation: Payment methodology in which the physician is paid a set dollar amount determined by a per member, per month calculation to deliver medical services to a specified group of people (like an IPA).

Carve‐Out: Medical services that are separated from a contract and paid under a different arrangement.

Case Management: A method by which a health plan attempts to control costs by directing all of the procedures for the care of an individual through a nurse or other healthcare professional.

Claim: Request for payment by a medical provider for a given medical service or item.

Consolidated Omnibus Budget Reconciliation Act (COBRA): Continuation of medical benefits once a member has left their employer.

Co‐Insurance: A percentage the patient is responsible for on a given insurance claim.

Contracted Provider (Participating): Provider that has an agreement with a health plan to accept their patients at a previously agreed upon rate for payment. They are deemed as "in‐network."

Copayment / Copay: A fixed dollar amount an insured person must pay when medical service is received.

Deductible: Set dollar amount which must be satisfied within a specified timeframe before the health plan begins making payments on a claim.

Explanation of Benefits (EOB): Summary of the payment made by your health plan to the medical provider.

Fee-for-Service: Method of payment for medical services rendered.

Fee Schedule: List of CPT codes and dollar amounts an insurance company will pay.

HCFA 1500: Standard claim form used by health plans on which to consider payment to the medical provider.

ICD‐9 / ICD-10: Standard format of identifying the illness, injury, or disease by using a three-digit to five-digit code.

Medical Necessity: Medical procedure or service must be performed only for the treatment of an accident, injury, or illness and is not considered experimental, investigational, or cosmetic.

Out‐of‐Pocket Expense: Amount the patient must pay (and not paid for by the insurance plan).

Pre‐Existing: Medical condition diagnosed prior to the effective date of the health plan.

Usual & Customary: Reduction in the payment of benefits on a claim which is justified by the insurance company as “the going rate” to be paid in that geographical area.

These are the most common ones I receive questions about, can you think of any others that might be helpful?

Keeping this list in a convenient place for your staff is a great tool for them to utilize when communicating with your patients.

Source from Physicians practice

EHR Cloud Computing Meets Moore's Law

Searching for a billing company who understands your emr ?

In an increasingly computerized world, understanding why and how computers do what they do can have a direct bearing on how you evaluate the effects on care that are the result of having the computer in the loop. Also, in the future, today's medical students are going to be making decisions about computerization and other technology. What will form the basis for their decisions — their "knowledge" of Facebook or how to text with two fingers? This raises the question: How knowledgeable, not "computer-literate," but knowledgeable are you?

Take cloud computing for example. It's the latest high-tech buzzword but do you have any idea what that is? A new national survey by Wakefield Research, commissioned by Citrix, suggests that the answer is "not really" — over half of respondents, including a majority of [supposedly computer literate] Millennials, believe that stormy weather can interfere with cloud computing.

How about Moore's Law? In 1965, Gordon Moore observed that technology seemed to be enabling the number of transistors on a microchip to double every two years. In 1970, Carver Meade dubbed this "Moore's Law." A graph of microchip production suggests that Moore was correct. Some physicists believe that Moore's Law, while it describes the past, does not predict the future. As transistors are made ever smaller they approach the size at which atomic forces come into play, effectively defining a minimum size, and hence a maximum speed, of the circuits in question. This limit may be reached in the next five years to 12 years.

Even if Moore's law should fail, faster computers are not precluded, but speed will have to be achieved in some other way such as deploying multiple processors working in parallel. I will return to Moore's Law in a moment, but first a discussion about the cloud.

The cloud is double talk — just a shorthand for computing that takes place somewhere other than inside your computer whether that be actual computations, data storage and retrieval, communications, or search. Some bright folks thought that the concept of "elsewhere" was too nebulous so. Instead they chose a term that connotes that most nebulous of things — a cloud.

The aspect of the cloud that is important to you, especially if you are considering a cloud-based EHR, is that the cloud is at the other end of a narrow pipe. Every bit of information that you send or request has got to pass through that pipe. While it is easy and cheap to buy a faster computer, it is neither easy nor cheap to buy a faster pipe. The speed and capacity of the pipe has not been doubling every two years, it has been doubling every eight years to 10 years and there is no guarantee when or if it will double again. Conclusion, connection speeds never have, and never will, experience the exponential growth of chips.

When you are using remote computing resources, the speed of your local computer is almost irrelevant — well not completely, but if it is a recent model it is. Speed is dependent on two factors: 1) how much processing capacity the remote site is willing to allocate to YOU; and 2) the bandwidth (speed) of your connection.

There is a third piece to this story — application complexity. Every time you ask your EHR vendor for a new feature or the feds add certification criteria that require additional program code, the demands placed on the system increase. If the code is running locally, you may be able to offset the increased demand with a faster processor.

If the code is running in the cloud and if it requires more data to be transferred back and forth between your location and the vendor’s site, then the performance that you experience will get progressively worse as the applications get more complex.

Since this slowdown has to do with the speed of the connection, not the speed of my computer, Moore's Law is irrelevant. If all computing is going to be cloud computing, I will never again need to buy a new computer — and I will become increasingly dissatisfied as the speed continues to degrade.

This is one of many reasons that I choose, as much as possible, to keep my computing local. You might want to carefully consider any decision to outsource your EHR to the cloud. Assuming that you choose an EHR that has the potential to "speed you up" if run locally, it could slow you down if run remotely, in the cloud.

Source from Physicians Practice 

Obama or Romney: Who Will Address Today's Healthcare Problems?

 Better Healthcare Billing services for Physicians !

Now that flags have been waived, the confetti has been … (not sure there is a verb for confetti) and the two party convention halls have grown quiet, it is time to refocus on the major issue facing the healthcare industry — an affordable healthcare plan for everyone. The President’s plan under the Affordable Care Act (ACA) calls for universal coverage through an “individual mandate.” People with no insurance must purchase it. Insurance companies may not deny coverage on a “newly discovered policy defense,” after the beneficiary falls ill.

The Republican plan seems to involve balancing the budget through some form of voucher system, which would reduce the government’s obligation to pay for Medicare and Medicaid. It is unclear, however, if the Republican plan intends to addresses the problems created by the masses of uninsured, or protect those who thought they were insured, until they needed benefits. This is simply a problem too great to ignore.

Any capitalistic free market is supposed to act according to the laws of supply and demand, which should hold down costs, and increase efficiency. This is the heart of conservative ideology. But American healthcare is no more capitalistic than China’s economy is purely communistic. What we have is a mixture of social programs and free enterprise. While this works well in many cases, in the healthcare context, the laws of supply and demand get out of balance. This is because of the unique health-related behavior of three primary groups.

In the first group, are those whose very intense efforts affect market availability, cost, and utilization. This group includes both the supply side — doctors, hospitals — and the demand side, those who must purchase services — employers, individuals, and insurers. A second group consists of the consuming public, who are not in the market, and feel the goings on in the market do not matter to them. Then, the third group is comprised of those consumers who thought they were in the second group, and therefore did not choose to be in the market. Instead, members of this group were thrust into the market – either by unhappy (illness) or happy (a new baby) circumstance — with no ability to pay for their needs and no advance thought to what they might do I when the bill comes due. Obviously, this is going to create a problem (and a national embarrassment) if Americans are allowed to die from lack of life-saving care.

What can’t happen usually won’t, but what we did in response to the “uninsured” problem is nothing short of absurd. Think of a Rubik’s Cube. The problem facing you is that one of the colored squares doesn’t fit. Rather than make the problem go away, you could simply turn the problem to make it face someone else. This is exactly what the government did with the unfunded mandate, the Emergency Medical Treatment and Active Labor Act (EMTALA), in which hospitals with emergency rooms cannot turn away patients suffering from an "emergency medical condition" (42 U.S.C. 1395dd).. This gift to the masses might have been defensible in the early and middle years of Medicare and Medicaid. During the halcyon days of fee-for-service and reasonable hospital reimbursement rates, it seemed not too much to ask those making a fortune from government programs to pitch in. The problem came from the “dog pile” which followed.

Once everyone figured out the government would not let us die from lack of care, there was no need to plan for that contingency. A mass migration of sorts occurred in which it was suddenly safe to be in the second or even third group of Americans who made no plan whatsoever to pay for illness. Economically, this has been devastating. Hospitals struggle to meet obligations, by raising the sticker price on everyone, which leads insurance companies to engage in post-claims underwriting (wait until an insured needs coverage, then find a flaw in the application to justify denial of coverage.) We are left with a non-functioning system described in hyperbole, as a “war of all-against-all,” in which “[i]nsurers cheat patients and doctors; patients cheat doctors and insurers; doctors cheat insurers and patients; and all cheat the federal governments." See, Bartlett, Donald; Steele, James, "Critical Condition– How Health Care in America Became Big Business and Bad Medicine," New York: Doubleday (2004) 

If we do not start demanding real solutions from our candidates to the problems created by EMTALA and the masses of uninsured, it seems clear we will not be able to avoid an eventual government takeover of the healthcare industry. This is because currently, there is nothing motivating people to take care of themselves. In fact, those who try to take care of their own needs, are often thrown back into the pile of uninsured, because they failed to disclose a sore throat, 10 years before a diagnosis of cancer.

This is a crisis of financing which transcends politics and traditional conservative and liberal ideology. This is our problem. Everyone needs care, and no one wants care delivered with the same enthusiasm as government employees at a department of motor vehicles. The best thing you can do is become active in your state’s medical association.

No matter who you vote for in November, find out what your association is doing, and how you can help ensure the survival of your industry.

Source from physicians practice  

Proposed DME Prescription Rule Adds More Burdens on Physicians

 Gear up Physicians, Its your turn now to increase your revenue. 

Medical offices rely on essential professionals like physician assistants (PAs), nurse practitioners (NPs), and clinical nurse specialists (CNSs) to increase practice efficiency and patient visits, as well as support the physician with providing quality medical care. However, Medicare’s recent proposed rule revising the conditions of payment for prescribing Durable Medical Equipment (DME) may cut these practice efficiencies and increase administrative burdens.

The proposed rule will require the physician to document and communicate to the DME supplier that he or their PA, NP, or CNS has met face-to-face with the patient no more than 90 days before the order is written or within 30 days after the order is written. Telehealth services are allowed in rural areas for physicians with an approved Medicare telehealth billing code (encounter is reported with a HCPCS code); however, face-to-face encounters exclude incident-to services. Although a majority of patients are seen before DME are ordered, this rule is expected to increase the number of office visits.

During a patient visit, the practitioner will evaluate the condition that supports the need for each DME ordered as well as conduct a needs assessment. The physician’s documented face-to-face encounter will be less cumbersome than that of a non-physician provider’s evaluation as it is sufficient for a physician to provide the DME supplier with his notes from the patient’s record regarding the patient’s history, physical examination, diagnostic tests, summary of findings, diagnoses, treatment plans, or other related information. If, however, a PA, NP, or CNS conducts the patient visit, the physician must also authorize the evaluation or attest to that meeting.

Attestation may require the physician to sign/cosign relevant sections of the patient’s chart; initial the patient’s history and physical examination for the date of the face-to-face meeting; or require the physician to actually write, sign, and date the following statement: “I, Doctor (Name) (NPI Number) have reviewed the medical record and attest that (PA, NP, or CNS) has performed a face-to-face encounter with (beneficiary) on (date) and evaluated the need for (the item of DME).”

Because physicians will spend extra time to review and authorize DME orders prepared by non-physician providers, Medicare will pay physicians $15 under a “G code” for that time. If a patient requires multiple DME orders and thus a lengthier review of the evaluation, the physician will receive one payment of $15 for the entire evaluation, provided that the physician does not separately bill an E&M code.

The written DME order must list: the patient’s name, item of DME ordered, NPI of the prescribing practitioner, prescribing practitioner’s signature, date of the order, beneficiary’s diagnosis, and necessary proper usage instructions (i.e., duration of use, correct positioning, utilization method) as applicable. If standard practice requires a DME order to have additional information, that order must include these seven minimum criteria and any additional necessary information to support a claim of payment.

The proposed rule significantly expands the list of covered DME items to include: (1) items that currently require a written order prior to delivery per instructions in the Medicare Program Integrity Manual; (2) items that cost more than $1,000; (3) items that Medicare Audit Contractors (MACs) believe are particularly susceptible for fraud, abuse, and waste; and (4) items that Medicare has determined are vulnerable to fraud, abuse, and waste. Medicare estimates that approximately 164 HCPCS DME codes are subject to the rule. Consequently, these criteria could make any DME item susceptible to the rule because MACs may subjectively find a DME item susceptible to fraud and abuse or inflation could push the cost past the $1,000 threshold.

It is also important that physicians check to see that they have properly drafted and signed collaboration agreements with their PA, NP, or CNS. Collaboration is a mutually agreed upon relationship between the non-physician provider and a physician educated, trained, and/or experienced in work related to the non-physician providers' work. Depending on the federal and state laws, the PA, NP or CNS can prescribe, dispense, and administer medical therapeutics or even evaluate the patient for a DME order without the physical presence of a supervising physician, if in collaboration with the physician. Any prescription or evaluation submitted to Medicare or Medicaid for payment without proper agreement, supervision, or reasonable review of a physician may be disallowed or viewed as susceptible to fraud, abuse, or waste.

The proposed face-to-face encounter rules will likely increase the physicians’ time spent on administrative functions. However, Medicare believes the potential reduction in fraud and abuse justifies the additional expenditure of time.

Source from Physicians Practice

Private School Parents Are More Likely to Opt Out of Vaccines

Pediatric billing now childs play !

Parents who send their children to private schools in California are much more likely to opt out of immunizations than their public school counterparts, an Associated Press analysis has found, and not even the recent re-emergence of whooping cough has halted the downward trajectory of vaccinations among these students.

The state surveys all schools with at least 10 kindergartners to determine how many have all the recommended immunizations. The AP analyzed that data and found the percentage of children in private schools who forego some or all vaccinations is more than two times greater than in public schools.

More troubling to public health officials is that the rate of children entering private schools without all of their shots jumped by 10 percent last year, while the opt-out figures held steady in public schools for the first time since 2004.

Public health officials believe that an immunization rate of at least 90 percent in all communities, including schools, is critical to minimizing the potential for a disease outbreak. About 15 percent of the 1,650 private schools surveyed by the state failed to reach that threshold, compared with 5 percent of public schools.

There were 110 private schools statewide where more than half the kindergartners skipped some or all of their shots, according to AP’s analysis, with Highland Hall Waldorf School in Northridge — where 84 percent opted out — topping the list.

Parents cite a variety of reasons for not immunizing their children, among them: religious values, concerns the shots themselves could cause illness and a belief that allowing children to get sick helps them to build a stronger immune system. Likewise, there’s no single explanation that accounts for why so many more parents who send their children to private schools apparently share a suspicion of immunizations.

Saad Omer, a professor of global health at Emory University in Atlanta who has studied vaccine refusal in private schools, surmised more private school parents are wealthy and have the time to spread five shots over a series of years and stay home should their child get an illness like chickenpox. Neal Halsey, a professor of pediatric infectious diseases at the Johns Hopkins University, said parents who choose private schools are likely to be more skeptical of state requirements and recommendations.

Bibi Reber, whose children attend the Waldorf-inspired Greenwood School in Mill Valley, had her children vaccinated only for what she sees as the deadliest diseases. Greenwood has a 79 percent opt-out rate among its kindergartners.

“I don’t think dirt or getting sick makes you a weak person; your immune system needs to work with things,” said Reber, whose children attend the Greenwood School in the San Francisco Bay area town of Mill Valley. “We certainly don’t want to go back to having polio, but on the other hand, I don’t think we need to eradicate all the childhood diseases

Public health officials say that, regardless of why parents choose not to vaccinate their children, the result is the same: an increased risk of an outbreak of whooping cough or other communicable diseases.

We’re very concerned that those schools are places where disease can spread quite rapidly through the school and into the community, should it get introduced,” said Dr. Robert Schechter, medical officer with the Immunization Branch of the California Department of Public Health.

That’s what prompted the Legislature to approve a bill requiring parents to discuss vaccinations with a pediatricians or a school nurse before they can opt-out. Gov. Jerry Brown has until the end of September to sign or veto it.

State Assemblyman Richard Pan, a pediatrician, who sponsored the bill, said he believes private school parents are more apt to mistakenly believe that the vaccinations themselves could be more dangerous than the diseases.

“In private school, these are people who have money, who are upper middle-class, and they are going on the Internet and seeing information and misinformation,” said Pan, D-Sacramento.

Increasing immunization rates for this population is critical to controlling the outbreak of diseases, he said. “Have you ever seen a child cough themselves to death? It’s not pleasant,” he said.

Those who choose not to vaccinate their children see the legislation as meddlesome and unnecessary.

“It’s making an extra appointment and paying extra money to go in there and essentially get permission to do what I feel is right for my family,” said Dawn Kelly, who sends her unvaccinated 5-year-old son and partially vaccinated 9-year-old son to Monarch Christian School in the Los Angeles area.

Like many parents who refuse some or all immunization shots, Kelly worries her children’s immune system could be overwhelmed by getting too many vaccines at once.

Melani Gold Friedman, president of the parent association at Highland Hall Waldorf School, is concerned with what the legislation means for families who normally consult with acupuncturists, holistic healers or other alternative practitioners.

“The bill has an assumption that everyone’s seeing one particular kind of doctor, but the people who are opting out, chances are they’re not seeing that kind of doctor,” she said.

Vaccination opt-out rates nationwide have been creeping up since the mid-2000s, spurred in part by the belief the battery of vaccinations routinely given to infants could lead to autism. Several major studies have discredited that idea.

Parents are allowed to forgo vaccines for philosophical reasons in California and 19 other states. Of those, only Washington requires parents to consult with a physician. And, in California, there’s no difference between private and public schools when it comes to what’s required for parents to opt out — they simply sign a document. The state recommends that kindergarteners receive five vaccine progressions, including protections against Polio, Hepatitis B and Measles

Politicians and public health experts across the nation are focusing more attention on childhood immunizations, driven by a re-emergence of diseases like whooping cough. The U.S. is in the midst of what could be its worst year for that disease in more than five decades, with nearly 25,000 cases and 13 deaths.
After whooping cough reached epidemic levels in California in 2010, the state took action, embarking on a public information campaign and increasing the availability of vaccines. A law was passed requiring booster shots for older students.

Yet the opt-out rate continued climbing in private schools. It’s more than doubled since 2004, to 2,228 kindergartners in last year’s state survey. While the overall rate of full immunization among kindergarteners hovers around 91 percent, places where the opt-out rate is greater could pose a risk for outbreak.

In 2008, East Bay Waldorf School in El Sobrante closed temporarily after whooping cough sickened more than a dozen students, eight of them kindergartners. The San Francisco Bay Area school had a vaccination rate of less than 50 percent.

State health officials are tracking the divergence of opt-out rates in private and public schools, but are not planning any studies or outreach efforts targeting this pupil population. The state is conducting a general education campaign to boost vaccinate rates.

The AP analysis found 20 of the 25 California private schools with the highest opt-out rates are “Waldorf schools,” a loose association of institutions founded on the teachings of 19th-century philosopher Rudolf Steiner. He favored a holistic approach to education and medicine and thought childhood illnesses could be beneficial.

Officials at these schools would not comment about Pan’s bill but say they trust parents to make the best decisions for their children’s health.

“Parents who are brave enough to say, ‘No, that’s not the right thing,’ should be supported,” said Patrice Maynard, spokeswoman for the Association of Waldorf Schools of North America.

—By HANNAH DREIER 

 Source from Heathland Time

Claims payment rule aims to cut red tape, save $9B

We follow the ERA and EFT method of posting payments

Health and Human Services Secretary Kathleen Sebelius released a new rule she says will cut red tape for doctors, hospitals and health plans. In combination with a previously issued regulation, she estimates the rule will save up to $9 billion over the next 10 years.

The regulation adopts operating rules for making healthcare claim payments electronically and describing adjustments to claim payments.

“These new rules will cut red tape, save money, and ensure doctors spend more time seeing patients and less time filling out forms,” said Sebelius.

Studies have found that the average physician spends three weeks a year on billing and insurance related tasks, and, in a physician’s office, two-thirds of a full-time employee per physician is necessary to conduct these tasks. Many physician practices and hospitals receive and deposit paper checks, and manually post and reconcile the healthcare claim payments in their accounting systems.

By receiving payments electronically and automating the posting of the payments, a physician practice and hospital’s administrative time and costs can be decreased.

The operating rules build upon industry-wide healthcare electronic fund transfer (EFT) standards that HHS adopted in January of this year. Together, the previously issued EFT standards and the EFT and electronic remittance advice (ERA) operating rules announced today are projected to save between $2.7 billion and more than $9 billion in administrative costs over 10 years by reducing inefficient manual administrative processes for physician practices, hospitals, and health plans.

Operating rules include best business practices on how electronic transactions are transmitted and often target obstacles that physician practices and health insurers have with using electronic transactions

For instance, the rule announced Aug. 7 requires insurers to offer a standardized, online enrollment for EFT and ERA so that physicians and hospitals can more easily enroll with multiple health plans to receive those transactions electronically.  The rule also requires health plans to send the EFT within a certain number of days of the ERA, which helps providers reconcile their accounts more quickly.

Today’s rule, Administrative Simplification:  Adoption of Operating Rules for Health Care Electronic Funds Transfers and Remittance Advice Transactions were developed through extensive discussions with industry stakeholders, Sebelius said. The rule adopts the Council for Affordable Quality Healthcare's Committee on Operating Rules for Information Exchange (CAQH CORE) Phase III EFT & ERA Operating Rule Set.

The regulation  will be effective upon its publication in the Federal Register on Aug. 10, 2012.  The comment period closes on Oct. 9, 2012.

The compliance date for operating rules for the health care electronic funds transfers and remittance advice transaction is Jan. 1, 2014.

Source From Physicians Practice