Worries about medicare providers

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Worries About Medicare Providers Agency, GAO Say Health Care Industry Lags on Y2K Issues

By Stephen Barr Washington Post Staff Writer Monday, September 27, 1999; Page A04

Doctors, hospitals, nursing homes and other health care providers in the Medicare program "still do not appear to be doing all that they must" to prepare for potential Year 2000 computer problems, the Clinton administration concludes in draft testimony prepared for a House hearing today.

In separate testimony, congressional auditors also worry that Medicare contractors processing benefit claims will run out of time before they can finish comprehensive Y2K tests aimed at finding glitches in data exchange systems.

Recent information on such tests "continues to be discouraging," the General Accounting Office says in draft testimony. Forty of 69 Medicare contractors--usually insurance companies--have tested with less than 1 percent of the doctors, hospitals and health providers who submit claims for payments, according to the testimony.

The draft testimony, prepared for a House Government Reform subcommittee chaired by Rep. Stephen Horn (R-Calif.), seems to reaffirm earlier findings that the health care industry lags on Y2K fixes and could face some financial consequences if billing and claims systems falter in January. By 2000, Medicare expects to process more than 1 billion claims and pay $288 billion in fee-for-service and managed-care benefits annually.

Last week, the special Senate committee assessing the Y2K problem gave high marks to a number of the nation's economic sectors but expressed concerns about the readiness of nursing homes and physician offices. "There are a lot of areas here where we don't have much information or where it seems as though not much has been done," Sen. Christopher J. Dodd (D-Conn.) said of the health care industry.

The Health Care Financing Administration, which oversees the Medicare program, has sent letters to more than 1.1 million health plans and providers stressing the importance of Y2K readiness. HCFA also has sponsored conferences, distributed "jump start kits" and set up a toll-free phone line, 1-800-958-4232, to provide information.

But it appears that doctors, hospitals and nursing homes have been reluctant to engage in Y2K tests and demonstrate their compliance, according to congressional auditors.

Gary Christoph, the chief technology officer at HCFA, acknowledges in his draft testimony that "we now see our greatest risk to the program as the uncertainties in the readiness of our partners, namely, our Medicare providers."

According to Christoph's testimony, "Virtually all of the surveys of provider readiness have fairly low response rates, and the anonymous responses are self-reported data, which may be overly optimistic. . . . We continue to have serious, ongoing concerns about the ability of some Medicare providers to successfully meet this challenge."

The Year 2000 computer glitch, known as Y2K, stems from the use in many systems of two-digit date fields, which may interpret "00" as 1900, not 2000, and malfunction or stop. Although Y2K fixes are relatively simple, coordinating and testing the fixes have created a big management problem, especially for agencies that regularly exchange data with contractors, nonprofits and local governments.

In his draft testimony, Christoph says the government computers that handle Medicare transactions have undergone extensive tests and "will be ready for the millennium." As proof, he reports that Medicare last month successfully received and processed enrollments from the Social Security Administration for beneficiaries who will be entitled to Medicare benefits on Jan. 1.

But the draft testimony by GAO Y2K expert Joel C. Willemssen, while praising Medicare's progress, stresses that HCFA's last round of internal tests will not end until November. Until then, Willemssen says, "the final status of the agency's Y2K compliance will remain unknown."

http://www.washingtonpost.com/wp-srv/WPlate/1999-09/27/048l-092799-idx.html

-- Homer Beanfang (Bats@inbellfry.com), September 27, 1999

Answers

We've concluded that, whatever idiocy, myopic tunnel selfish laziness contributed to the Y2K catatonicastrophy, NOW it has become a .system conscious Cull Opportunity. Big fast way to eliminate all that enormous drain of Medicare, Medicaid, Social Security, etc.

Entitlement Coffers to Coffins. Koffinsky in charge. Let's reinvent Government!

Stocking streamlined shrouds ... think they've gotten that far, the .gov .system .biz .establishment with quick nitty-gritty-grungy for-real COVER-UPS, contingency plans "final solutionized?" Got grave diggers? Got enough crematoriums?

-- Ashton & Leska in Cascadia (allaha@earthlink.net), September 27, 1999.


Shorter snip in Merc...

Published Monday, September 27, 1999, in the San Jose Mercury News
NATIONAL AND WASHINGTON NEWS IN BRIEF

http://www.mercurycenter.com/premium/nation/docs/ natdig27.htm

[snip]

Medicare readiness for 2000 worries U.S.

Doctors, hospitals, nursing homes and other health care providers in the Medicare program ``still do not appear to be doing all that they must'' to prepare for potential year 2000 computer problems, the Clinton administration concludes in draft testimony prepared for a House hearing today.

In separate testimony, congressional auditors also worry that Medicare contractors processing benefit claims will run out of time before they can finish comprehensive Y2K tests aimed at finding glitches in data- exchange systems.

Recent information on such tests ``continues to be discouraging,'' the General Accounting Office says in draft testimony. Forty of 69 Medicare contractors -- usually insurance companies -- have run tests with fewer than 1 percent of the doctors, hospitals and health providers who submit claims for payments, according to the testimony.



-- Diane J. Squire (sacredspaces@yahoo.com), September 27, 1999.


* * * 19990927 Monday

... 'Recent information on such tests ``continues to be discouraging,'' the General Accounting Office says in draft testimony. Forty of 69 Medicare contractors -- usually insurance companies -- have run tests with fewer than 1 percent of the doctors, hospitals and health providers who submit claims for payments, according to the testimony.'

Hmmm... I wonder if Blue Cross Blue Shield of Michigan (BCBSM) is in that group of 40--58%(!)of the 69--Medicare contractors?

Is EDI (External Data Interchange) testing with 1% of your customer base considered "due diligence?" I think not!

How much of the national health care industry dollars--14% of GDP (Gross Domestic Product)!!--does Medicare/Medicaid/VA account for?!? After all, the same medical providers ARE THE SAME PROVIDERS THAT THE PRIVATE SECTOR DEALS WITH!!

It was from ~20,000 _NON-RESPONSIVE_ doctors, hospitals, clinics that BCBSM realized (in May 1998!) their golden Y2K remediation was doomed.

Health insurance companies are Y2K burnt toast.

This scenario points to interconnectedness that will generate domino failures.

EVERYONE HAS A "Y2K FALL GUY!" Take your pick. It was the self- proclaiming Y2K compliant: power company; telecom company; banksters; supplier/s; et al.

Another related issue that could affect the NUMBER of PROVIDERS is whether these providers will be able to meet Y2K equipment requirements from the insurance companies that provide malpractice insurance. If they can't certify their medical equipment, insurance policies will not be issued and they'll be out of business.

This is another sticky wicket that medical insurance carriers hadn't considered as late as mid-1998! I spoke with an individual at BCBSM responsible for certifying the insurance status of their authorized providers that was absolutely clueless and stunned when I informed her of the possibility as published in a newspaper story. I'll never forget that day! I made her day!

Y2K accountability is actually a bad, sick, sad, criminal--for lack of _timely_ public/stockholder disclosure/s--joke!

... Y2K-Wake up, America!

Regards, Bob Mangus

* * *

-- Robert Mangus (rmangus1@yahoo.com), September 27, 1999.


http://dailynews.yahoo.com/h/ap/19990927/tc/y2k_medicare_1.html

[Fair Use: For Educational/Research Purposes Only]

Monday September 27 4:51 PM ET

Medicare Y2K Readiness Questioned

By JIM ABRAMS Associated Press Writer

WASHINGTON (AP) - Lawmakers and health care experts said Monday they were concerned that doctors, hospitals and other Medicare health insurance providers will not be prepared to handle the Y2K computer problem.

``The outlook is alarming,'' said Rep. Stephen Horn, R-Calif., chairman of the House Government Reform subcommittee monitoring the year 2000 computer issue. As of last week, he said, less than 2 percent of the 230,000 hospitals, nursing homes, doctors and other health care providers who submit claims to Medicare had tested their computer systems with Medicare contractors.

Gary Christoph, chief information officer for the Health Care Financing Administration, which oversees the Medicare program, told Horn's panel that the HCFA has fixed its internal computer systems and sees no interruptions from its end in servicing the 39 million senior citizens eligible for Medicare.

But he agreed that ``we now see our greatest risk to the program as the uncertainties in the readiness of our partners; namely, our Medicare providers.''

What has worried those monitoring the health care industry is the low level of response to surveys seeking information from doctors and hospitals about Y2K compliance, and how few of those responding have actually tested to ensure their computers are ready for the turn of the century.

Until tests are carried out, said Joel Willemssen of the General Accounting Office, the investigative wing of Congress, ``the ability of these entities to process Medicare claims in a future date environment is unknown.''

Christoph said the HCFA is carrying out an extensive outreach program involving an 800-number, a Web site (www.hcfa.gov/y2k), year 2000 ``jump start kits'' and mailings to its 1.1 million Medicare providers.

He said all Medicare managed care organizations are required to certify that their systems will perform into the new millennium, but reviews of the contingency plans for national chains indicate that while 50 percent are reasonable or in need of minor improvements, the other 50 percent need major improvements.

The nearly 7 million in Medicare HMO programs require preauthorization for speciality care, said Joseph R. Baker of the Medicare Rights Center, and computer breakdowns could mean that these people can't get authorization for the care they need, ``with potentially devastating consequences.''

Dr. Whitney Addington, president of the American College of Physicians-American Society of Internal Medicine, said there is a high level of Y2K awareness among doctors and many have taken corrective measures. But many haven't tested their systems, he said, and this could lead to a ``last minute 'debugging' demand that could overwhelm available resources.''

Last week the Senate panel following Y2K developments, in a report on the status of Y2K compliance 100 days before the new year, also pointed to the health care industry as an area of major concern. It concluded that while large hospitals and federal agencies such as the HCFA are in good shape, there was a real possibility of disruptions at the local doctor and rural or small inner-city hospital level.

Many older computers read only the last two digits of the year, and will not be able to differentiate between 2000 and 1900. That could cause computer systems to malfunction or break down.

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-- Linkmeister (link@librarian.edu), September 27, 1999.


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