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HHS/CMS

RIN: 0938-AM22

Publication ID: Fall 2002

Title: ●Electronic Medicare Claims Submission (CMS-0008-P)
Abstract: This proposed rule implements the requirements for electronic submission of Medicare claims, submitted on or after October 16, 2003. In addition, this rule also implements the conditions upon which a waiver could be granted for these requirements.
Agency: Department of Health and Human Services(HHS)	Priority: Other Significant
RIN Status: First time published in the Unified Agenda	Agenda Stage of Rulemaking: Proposed Rule Stage
Major: No	Unfunded Mandates: No
CFR Citation: Not Yet Determined (To search for a specific CFR, visit the Code of Federal Regulations.)
Legal Authority: PL 107-105

Legal Deadline: None

Statement of Need: Needed to state how we will implement the Administrative Simplification Compliance Act (ASCA), Public Law 107-105. It requires the electronic submission of Medicare claims, although the Secretary has the authority to grant waivers. This requirements applies to claims on or after October 16, 2003.

Summary of the Legal Basis: Public Law 107-105

Alternatives: If we do nothing, it demonstrates the Department's lack of commitment to HIPAA and its enforcement.

Anticipated Costs and Benefits: Will have an impact on the Medicare contractors budget but the magnitude is unknown at this time. A presumed benefit is that providers will choose to switch to electronic claims submissions.

Risks: Providers may choose not to participate in Medicare.

Timetable:

Action	Date	FR Cite
Proposed Rule	03/00/2003

Regulatory Flexibility Analysis Required: Undetermined	Government Levels Affected: None
Federalism: No
Included in the Regulatory Plan: Yes
Agency Contact: Elizabeth Holland Director, HIT Initiatives Group Department of Health and Human Services Centers for Medicare & Medicaid Services Office of E-Health Standards and Services, Mail Stop S2-26-17, 7500 Security Boulevard, Baltimore, MD 21244 Phone:410 786-1309