NCPDP D.o Penalties Temporarily Delayed for Noncompliant
Providers
On November 17, 2011, the Centers for Medicare & Medicaid
Services (CMS) announced that it will delay enforcement of the
required Health Insurance Portability and Accountability Act
(HIPAA) new ASC X12 Version 5010 (Version 5010), the National
Council for Prescription Drug Programs (NCPDP) Telecom D.0 (NCPDP
D.0), and NCPDP Medicaid Subrogation 3.0 (NCPDP 3.0) standards for
electronic healthcare claims until March 31, 2012. Please note:
This is not a delay of the January 1, 2012 required compliance
date, but a delay in the enforcement of penalties associated with
provider's noncompliance.
Providers are expected to be compliant January 1, 2012, but the
Indiana Health Coverage Programs (IHCP) will accommodate the grace
period by accepting both versions D.0 and 5.1, and batch 1.1 and
1.2 claims starting January 1, 2012, for a period of time to be
determined by the IHCP.
The submission of 5.1 claims will be closely monitored. If your
pharmacy will not be ready to comply with the new HIPAA standards
January 1, 2012, you must submit an email with a subject line
stating "Noncompliance." The body of the email must contain your
National Provider Identifier (NPI), the date you will be ready, and
what steps you are taking to become compliant. Providers or their
representative headquarters must send the email to INXIXpharmacyd0@hp.com
no later than December 21, 2012. The IHCP reserves the right to
discontinue acceptance of 5.1 claims at any time within the 90-day
grace period. Please monitor indianamedicaid.com for future
notifications.
Providers must use new forms for paper claims and adjustments
beginning January 1, 2012. The new paper forms can be found on the
Forms
page of indianamedicaid.com on or after December 15,
2011.