5010 enforcement delayed until June 30


If you haven?t yet complied with HIPAA Version 5010 deadline, you have a little more time.

If you haven’t yet complied with the HIPAA Version 5010 deadline, you have a little more time.

The Centers for Medicare and Medicaid Services’ (CMS) Office of E-Health Standards and Services (OESS) announced last week that it will delay the start of enforcement action for an additional 3 months-until June 30-against any covered entity that is required to comply with the standard.

November 17, OESS announced that, for a 90-day period, it would not initiate enforcement action against any covered entity that was not compliant with the updated versions of the standards by the January 1, 2012, deadline. The decision was referred to as enforcement discretion, and during this period covered entities were encouraged to complete outstanding implementation activities including software installation, testing, and training.

CMS is reporting successful receipt and processing of more than 70% of hospital claims and 90% of physicians’ claims in the Version 5010 format, according to OESS. Commercial plans are reporting similar numbers.

OESS expects that transition statistics will reach 98% industry-wide by the end of the enforcement discretion period.

CMS will host provider calls to address outstanding issues related to 5010. As of press time no related calls were scheduled. To check for upcoming calls and learn how to register, visit

If you are having difficulty reaching your Medicare contractor about a 5010 issue, OESS says to contact Karen Jackson at

Go back to current issue of eConsult

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