After Oct. 1, CMS to return noncompliant transactions

The Centers for Medicare & Medicaid Services (CMS) has announced electronic claims that are noncompliant with the Health Insurance Portability and Accountability Act (HIPAA) will not be processed after Oct. 1, 2005.

CMS will process these claims prior to Oct. 1, but after that date, noncompliant claims will be returned to providers for resubmission as compliant claims.

This action ends a portion of a CMS' HIPAA contingency plan in effect since Oct. 16, 2003, under which Medicare continued accepting noncompliant electronic claims after the deadline.


JCAHO expectations for 2006 patient safety goals

Organizations accredited by the Joint Commission on the Accreditation of Healthcare Organizations can see detailed implementation expectations for the 2006 National Patient Safety Goals on the Joint Commission web site.

Two new goals that must be implemented by January 2006 include a standard approach for handoff communications and implementation of a fall reduction program.

To meet the new goal regarding handoff communications, implementation expectations include:

  • Limit interruptions during communications.
  • Present up-to-date information.
  • Verify information.
  • Provide an opportunity for the receiver to review information and ask questions of the giver.

Meeting the fall reduction program requirement should include consultation with a pharmacist who can identify medications most likely to affect a home care patient's risk for falls.

To see a complete list of implementation expectations, go to www.jcaho.org. Under "Top Spots," choose "National Patient Safety Goals and FAQs," and scroll down to "2006 Implementation Expectations."