CMS Will Not Enforce Version 5010 Through June

CMS' Office of E-Health Standards and Services announced it will not enforce Version 5010, D.0 and 3.0 electronic transaction standards for hospitals, physician practices and other HIPAA-covered entities through June 30, 2012 — the second three-month extension that has been issued.

In November, the OESS announced it would not "initiate enforcement action" against any covered entity that was not compliant with the Version 5010 standards by the Jan. 1, 2012, compliance date and allowed an enforcement discretion period through March 31, 2012. This original decision was based on feedback from providers and trading partners. The OESS decided to delay compliance again because there "are still a number of outstanding issues and challenges impeding full implementation," according to the release.


The OESS said providers, health plans, clearinghouses, billing vendors and software vendors have made "steady progress" in the transition to Version 5010. Currently, Medicare is reporting successful receipt and processing of more than 70 percent of all Part A claims and more than 90 percent of all Part B claims. Some state Medicaid agencies have also made the full transition to Version 5010.

CMS, the OESS and all other affiliated parties will continue to address the "outstanding issues," including those with Medicare Administrative Contractors, and CMS expects this extension can "ensure that all entities can complete the transition."

Related Articles on Version 5010:

4 Fact Sheets on Version 5010

In the Fog of Delay: What's Next for ICD-10?

3 Issues to Monitor in the Upgrade to Version 5010

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