Beginning January 1, 2012, all U.S. Health Insurance Portability and Accountability Act (HIPAA)-covered entities must transition from the current HIPAA 4010/4010A standards for the transmission of healthcare transactions to HIPAA 5010 standards. As of this date, transactions that were accepted electronically under the 4010/4010A version must be submitted in the 5010 format. Any transaction that does not meet the criteria of the 5010 standards will be rejected by commercial and private insurers. The transition from 4010 to 5010 standards has been on the industry radar for a couple of years now, and the deadline to transition has been reset multiple … Continue Reading →

It is well understood that the U.S. healthcare system is under tremendous pressure from all directions. Government fee reductions, declining private-sector program enrollments, provider and supplier cost and price increases, and uncertainties of impending regulatory change are simultaneously impacting healthcare economics. What is not so well understood are the repercussions of this pressure beyond the healthcare system. One relevant and glaring case in point is the significant and growing practice of cost shifting — charging the nation’s property and casualty (P&C) insurance companies, specifically the automobile insurance segment, for medical-provider services. This leakage has been masked until now by lower-than-usual … Continue Reading →

This week we learned that health insurance premiums have increased by around 9% over the past year, most of which is currently covered by employers. This increases the burden of healthcare costs on employers, and on smaller employers in particular. Further, the constant rise in premiums raises red flags about how coverage is going to be handled by smaller employers already teetering on the edge of being unable to provide insurance coverage for their employees. The rise will likely shift momentum toward more employers opting to provide cheaper plans with higher deductibles and fewer benefits. The consumer-directed healthcare plan market, … Continue Reading →

Yes, the United States does have a Chief Technology Officer — our first ever — and after hearing Aneesh Chopra speak, one could easily conclude that President Obama created the position specifically for him. As noted on the White House website, “our mission is to assist the President in harnessing the power and potential of technology, data and innovation to transform the Nation’s economy and improve the lives of everyday Americans.” And that is exactly what he is doing. The affable Mr. Chopra energized a packed room of Chicago’s tech faithful with his keynote speech Friday at the Chicago Techweek conference. … Continue Reading →

Another year of NACHA’s Payments conference has come to a close. The exhibit floor has emptied, and attendees have headed back to their homes and offices. The Payments conference has a collegial feel; as described by one attendee, “I’m with my tribe.” It is true that many people return year after year. Just as we catch up with each other, we catch up with industry trends and new topics. The keynote address this year focused on payments challenges and opportunities in healthcare. That speech set the stage for the inaugural healthcare track of presentations — many banks and technology vendors … Continue Reading →