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Get Hip to HIPAA
Just when you thought California HIPAA laws could not become more complex…ta-da!...new issues arise for 2007. So what new developments have hit the horizon? Are there more to come this year? Let’s explore the first half of the year, and then look ahead. Getting hip to the newest batch of HIPAA guidelines will prepare you for the ever-changing landscape of employee benefits gurus.
Know Your NPI’s
The story on National Provider Identifiers, or NPI’s, started the end of 2006 when all Medi-Cal providers submitting electronic claims ceased using proprietary non-HIPAA compliant claims. The one exception to this was the Child Health and Disability Prevention claims known as type 11, which will be addressed by the end of 2007. To avoid the dreaded disruption of cash flow to your organization, NPI’s are required on claims sent on or after May 23rd, 2007. Every healthcare provider needs to have an NPI, except for providers considered atypical.
Close to Home
As of November 1, 2006, the California Department of Health Services started allowing only HCPCA Level II codes and modifiers when billing for the Home and Community-Based Services (HCBS) waiver programs. In addition, HCPCS Level III codes and modifiers will no longer be reimbursable by Medic-Cal.
The question now becomes “what about previously authorized services?” Those of you with this issue can be assured that HCPCS Level III codes and modifiers will be paid up to May 31st, 2007.
Drug Details
The National Drug Code (NDC) is not exempt from changes to comply with the newest HIPAA requirements. Federal law currently requires state Medicaid programs to use NDC’s or HCPCS Level II codes to report single-source, physician-administered drugs for the purpose of collecting and submitting utilization data. But, the federal Deficit Reduction Act of 2005 required state Medicaid programs to also begin using NDC’s to secure rebates for multiple-source and single-source, physician-administered drugs no later than January 1st, of 2007, unless the U.S. Department of Health and Human Services specified that an alternative coding system could be utilized.
The state of California Assembly Bill 2631 requires CDHS to develop and publish medical benefits and utilization policy for injectable drugs within 180 days of FDA approval. Growth in the number of physician-administered drugs are also bringing some issues to light. First, physician administered drugs are often excluded from rebates since the billing cod does not always identify the specific drug and drug units at the claim level. Second, drug manufacturers pay more than $1 billion in rebates to the Medi-Cal Program annually for those drugs dispensed by pharmacies, and are concerned about how this will affect their payout.
The Year to Come
The California Department of Health Services has already made some recommendations for 2008 with regard to the National Drug Codes, including both pharmacy and non-retail drugs.
The first suggestion is for the use of Medi-Cal interim codes (X codes) for physician-administered drugs to be discontinued altogether. Providers would then be required to submit both the specific HCPCS code and the NDC for these physician-administered drugs. Reimbursement would then be based on the NDC.
Next, the CDHS also recommends that the NDC be supplied for claims with CPT-4 codes for vaccines, again with the reimbursement based on the NDC. These code groups would include the categories of blood factor, blood products, chemotherapy, injections and vaccines.
With all of the new HIPAA changes, and those to come, privacy and accuracy become even more paramount when dealing with both employee and patient records. Although electronic filing and paperless records is becoming more efficient, the security of these records still must be the first concern of the human resources and employee benefits professionals. Keep in mind that as the requirement for privacy grows, so do the legal issues surrounding them.
Our job is to keep you informed of these changes, and how they affect your organization.--------------
Thank you!
