Friday, September 12th 2003

To: HIAA, AAHP, BCBSA, TriCare, State Medicaid Directors, and American Public and Human Services Association

As you know, numerous health care provider groups have been actively seeking to ensure a smooth transition to the HIPAA Transactions and Code Sets Standards.  We are very concerned that without sufficient flexibility, not only in enforcement of the rule by the Centers for Medicare and Medicaid Services (CMS), but also by payers in announcing deploying adequate contingency plans, it is likely that there will be widespread confusion and disruption in claims processing.

We appreciate your willingness to work with us on this issue.  We know that your members are also working towards a smooth transition and that everyone shares the common goal of avoiding a major disruption in claims processing on October 16th and thereafter.

On September 4th as you know, Tom Grissom, Director of the Center for Medicare Management, announced that CMS is currently assessing the readiness of its trading partner community to determine whether it will deploy a contingency plan for Medicare fee-for-service operations.  CMS will make a decision on whether to deploy the contingency by September 25, 2003.  If the contingency is deployed, Medicare would continue to accept and send transactions in legacy formats as well as HIPAA compliant formats while they and their trading partners work through issues related to implementing the HIPAA standards.

In a just released list of frequently asked questions, CMS urges all health plans to announce their contingency plans as soon as possible to allow their trading partners enough time to make any needed adaptations to their business operations to ensure minimal disruptions. In these answers, CMS makes clear that an acceptable contingency plan would ensure the smooth flow of payments to providers and could include, for example, maintaining legacy systems, flexibility on data content, or interim payments. The undersigned physician and provider groups would like to inform our members as soon as possible about the specific contingency plans your constituent organizations have established for claims processing and maintaining the smooth flow of payments to providers.  Further, we urge you to publish any contingency guidance you have developed on your website and broadcast it widely to your members. 

To ensure that we can provide timely information to our respective members and give them time to make appropriate adjustments to their business operations, we urge you to let us know about your members' contingency plans before September 25th.  Your response should be directed to Alan Mertz at the American Clinical Laboratory Association at 1250 H. Street NW, Suite 880, Washington, DC 20005 or by e-mail to:
Thank you in advance for your cooperation.


American Academy of Audiology
American Academy of Dermatology Association
American Academy of Facial, Plastic and Reconstructive Surgery
American Academy of Family Physicians
American Academy of Ophthalmology
American Academy of Otolaryngology ˆ Head and Neck Surgery
American Academy of Pediatrics
American Academy of Physical Medicine and Rehabilitation
American Academy of Physician Assistants
American Academy of Sleep Medicine
American Association of Clinical Endocrinologists
American Association of Neurological Surgeons
American Association of Orthopaedic Surgeons
American Clinical Laboratory Association
American College of Cardiology
American College of Nuclear Physicians
American College of Obstetricians and Gynecologists
American College of Osteopathic Surgeons
American College of Physicians
American College of Radiology Association
American College of Surgeons
American Gastroenterological Association
American Health Care Association
American Hospital Association
American Medical Association
American Medical Group Association
American Nurses Association
American Optometric Association
American Osteopathic Academy of Orthopedics
American Osteopathic Association
American Physical Therapy Association
American Podiatric Medical Association
American Society for Clinical Pathology
American Society for Therapeutical Radiology and Oncology
American Society of Anesthesiologists
American Society of Neuroradiology
American Society of Plastic Surgeons
American Speech-Language-Hearing Association
Association of American Medical Colleges
College of American Pathologists
Congress of Neurological Surgeons
Federation of American Hospitals
Infectious Diseases Society of America
Laboratory Corporation of America
National Association for Medical Direction of Respiratory Care
National Association of Social Workers
National Medical Association
NASPE ˆ Heart Rhythm Society
National Rural Health Association
North American Spine Society
Quest Diagnostics, Incorporated
Premier, Inc.
Renal Physicians Association
Society of Critical Care Medicine
Society of Interventional Radiology
Society of Nuclear Medicine
The Endocrine Society
VHA Inc.

Jared Adair,CMS
Tom Grissom, CMS
Leslie Norwalk, CMS
Dennis Smith, CMS
Alissa Fox, BCBSA
Teresa Doyle, BCBSA
Henry Desmaris, MD, HIAA
Michael DeCarlo, HIAA
Diana Jost, AAHP
Thomas Wilder, AAHP
Thomas Gill


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