Consistent with the latest statement issued by the Centers for Medicare & Medicaid Services (CMS), AmeriHealth will observe a second 90-day grace period for enforcement of the new HIPAA 5010 transaction standards. This second grace period will expire on June 30, 2012.

The original rule from the U.S. 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. In late 2011, CMS issued a statement announcing a grace period of the enforcement of the new HIPAA 5010 transactions standards through March 30, 2012. CMS has issued a second statement extending the grace period to June 30, 2012.

AmeriHealth will comply with the HHS rule to move to 5010 standards. However, AmeriHealth will continue to accept and remit 4010A transactions through the recommended 90-day enforcement grace period, ending on June 30, 2012.

If you are not prepared to issue and accept HIPAA 5010-compliant transactions by June 30, 2012, you may be adversely affected by conversion activities initiated by AmeriHealth and/or your trading partner (clearinghouse/vendor). We encourage you to continue working with your trading partners to ensure your preparedness and to avoid any negative outcomes during this transition.

If you have any questions concerning your preparedness for the transition to 5010, please contact your trading partner (clearinghouse/vendor).