Medicare, managed care organizations behind on Y2K work

Many of the nation's Medicare providers and managed care organizations have not taken the necessary steps to ensure their computer systems will be Year 2000-compliant, according to the Department of Health and Human Services.

Surveys conducted by the department's inspector general, in addition to on-site evaluations by the Health Care Financing Administration, concluded that those health care organizations made significant improvements in their Year 2000 readiness plans in the first half of the year. But the surveys, conducted in July, showed weaknesses in the compliance of billing systems.

The two self-reported surveys, one of Medicare managed care companies and the other of fee-for-service providers, found that about 85 percent of managed care respondents claimed they were Year 2000 ready. About 66 percent of fee-for-service providers reported that their billing and medical records system were compliant.

The surveys and site visits also showed that 67 percent of contingency plans submitted to HCFA in August from managed care organizations needed major or complete revision. In addition, one-third of fee-for-service providers had not tested the readiness of their systems. Also, a large number of fee-for-service agencies did not respond to the survey, leaving their current status and future readiness unknown.

If health care providers experience problems generating electronic claims and must use paper next year, it will take longer for the government to pay claims, said HCFA chief information officer Gary Christoph. He said the law requires HCFA to respond to electronic claims in 14 days, a time span that nearly doubles to 27 days for paper-based claims.

Year 2000 resources for health care providers are available online at www.medicare.gov/y2k, or toll-free at (800) 958-4232.