Medicaid Compliance – New Posting
December 29th, 2011 | 
Author: The Office of the Medicaid Inspector General has posted its latest Compliance Alert (#8) on the OMIG Web site entitled, “Home Health Care Provider Self-Assessment Pre-Claim Review Process.”
This alert is in regards to the changes made on March 31, 2011, Social Services Law Section 24 and Section 363-e5 were amended to require use of a verification organization to conduct pre-claim reviews of Medicaid services and items and to provide exception and conflict report data6 for the following providers with total Medicaid reimbursements exceeding $15 million per calendar year:7 certified home health agencies (CHHAs); long term home health care programs (LTHHCPs); and personal care providers.
Here is a link for the entire alert. http://www.omig.ny.gov/data/images/stories/compliance_alerts/compliance_alert%202011_08_home_health_verification.pdf
Posted in General, Medicaid, New York | 
Tags: 5010 compliance, administration, AIDD, audits, CMS, Community Living, DDSO, Developmental Disabilities, DSP's, HIPAA, ICF/MR, Incident Management, information, management, Medicaid, MSC, New York, NYSACRA, NYSARC, NYSRA, OMIG, OPWDD, Regulations, Service Coordination, Waiver | 
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Medicaid Billing and 5010
Hello everyone,
Effective January 1, 2012, a federal mandate requires that providers use the HIPAA Version 5010 standard for electronic claim transactions. We are pleased to announce that Therap has implemented Version 5010 related changes that will impact all providers using Electronic Billing. We have available a summary of the required changes to provide you with information that will assist you in meeting the January 1, 2012 compliance requirement.
It is important that providers review and understand the changes detailed in this document and take necessary actions to ensure successful transition to 5010.
If you have any questions regarding 5010, please contact Therap Support at support@therapservices.net.
Posted in General, Medicaid, New York |
Tags: 5010 compliance, administration, AIDD, audits, CMS, Community Living, DDSO, Developmental Disabilities, DSP's, HIPAA, ICF/MR, Incident Management, information, management, Medicaid, MSC, New York, NYSACRA, NYSARC, OPWDD, Regulations, Service Coordination, Waiver |
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Medicaid – Billing – and HIPAA 5010
Once again Therap Services are ready for change. When providers need to be in compliance to changes in regulations or forms we are always there. Now we are ready for the new billing requirements referred by HIPAA standard as 5010.
Here is a blurb about what this means to us and the providers of New York.
5010 – D.0
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HIPAA Standards The Centers for Medicare and Medicaid Services (CMS) is underway with implementation activities to convert from Health Insurance Portability and Accountability Act (HIPAA) Accredited Standards Committee (ASC) X12 version 4010A1 to ASC X12 version 5010 and National Council for Prescription Drug Programs (NCPDP) version 5.1 to NCPDP version D.0. The Secretary of the Department of Health and Human Services (HHS) has adopted ASC X12 version 5010 and NCPDP version D.0 as the next HIPAA standard for HIPAA covered transactions. The final rule was published on January 16, 2009. Some of the important dates in the implementation process are: Level I compliance means “that a covered entity can demonstrably create and receive compliant transactions, resulting from the compliance of all design/build activities and internal testing.” Level II compliance means “that a covered entity has completed end-to-end testing with each of its trading partners, and is able to operate in production mode with the new versions of the standards.” |
Posted in General |
Tags: 5010 compliance, administration, AIDD, audits, CMS, Community Living, DDSO, Developmental Disabilities, DSP's, HIPAA, ICF/MR, Incident Management, information, management, Medicaid, MSC, NYSACRA, NYSARC, OMIG, OPWDD, Regulations, Service Coordination, Waiver |
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