Consistent with the recent statement issued by the Centers for Medicare & Medicaid Services (CMS), AmeriHealth will be observing a 90-day grace period for enforcement of the new HIPAA 5010 transaction standards.

The original rule from the Unites States Department of Health and Human Services (HHS) stipulated that any health care entity that submits electronic standard transactions must comply with HIPAA 5010 (errata version) by January 1, 2012. AmeriHealth will comply with the HHS rule to move to 5010 standards. However, AmeriHealth will continue to accept and remit 4010A transactions past the original compliance date of January 1, 2012, through the recommended 90-day enforcement grace period. This grace period will expire on March 31, 2012. In addition, we will accept HIPAA 5010 (errata version) transactions beginning with the original compliance date of January 1, 2012.

If you are not prepared to issue and accept HIPAA 5010-compliant transactions by March 31, 2012, you may be adversely affected by conversion activities initiated by AmeriHealth and/or your trading partners. We encourage you to continue working with your trading partners to ensure your preparedness and to avoid any negative outcomes.

If you have any questions about your preparedness for the transition to 5010, please contact your trading partners.