Medicare....Pfffffft!!.................Paul Milne

greenspun.com : LUSENET : TimeBomb 2000 (Y2000) : One Thread

Here is an interesting story about Medicare, something to consider if you have elderly parents or others currently using Medicare!

snooze button

-- Before you read this article I want you to think about alan decher's comments. dechert claims that Y2K is a hoax that will have ZERO economic consequences. None at all. Zip. Nada.

This is only one small small small corner of the BEST PREPARED NATION on earth.

One small corner of one small industry, not to mention the countless other industries.

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Medicare hears bleak diagnosis of Y2K readiness

The Millennium Bug may hit the electronics claims system that pays physicians and hospitals

Friday, November 12, 1999

By Steve Woodward of The Oregonian staff

Medicare's chief information guru calls it "a much bigger problem than I anticipated."

(No shit. Since day one I have repeatedly stated that they are grotesquely underestimating the scope an magnitude of the problem.)

A Medicare contractor calls it a "really grave" concern.

An Oregon medical industry executive calls it "a potentially lethal situation."

They aren't talking about the Ebola virus. They're talking about a bug of a different sort: Y2K.

The Year 2000 computer problem has lodged itself in the weak spot of the nation's Medicare system, which provides medical insurance coverage for 38 million elderly and disabled Americans. That weak spot is the computerized connection between the nation's 800,000 doctors and Medicare's 75 contractors, which process claims on behalf of the federal government.

If the electronics claims system doesn't work, physicians wouldn't be paid by Medicare for weeks, if at all.

Even in cases where both Medicare and physicians have Y2K-ready computer systems, the electronic partners are experiencing failure rates of as much as 20 percent when they hook their systems together in tests.

( Whoa! Even what they claim is compliant is going haywaire at a rate of twenty percent.)

But the fact that worries Medicare watchers the most is that 98 percent of the nation's doctors, hospitals and other health providers haven't yet tested their systems with Medicare, according to an Oct. 11 report in American Medical News, published by the American Medical Association.

( Go figure. Testing, only the single most important part of the remediation, and they have not done it. fifty days to go and they were all going to be done and have a YEAR FOR TESTING.)

"We have no reason to believe that physicians in Oregon are any different than physicians in the rest of the country," said James Kronenberg, associate executive director of the Oregon Medical Association. "This is a potentially lethal situation."

( Exactly. There is not a single reason to believe that the entire country is not like this)

Claims-filing failures wouldn't be lethal to patient care. But significant disruptions in the Medicare reimbursement system -- either from improperly submitted claims or from a surge in paper claims -- could create cash-flow nightmares for medical clinics and hospitals that rely on reliable Medicare payments to keep their operations going.

( Yes, it would be lethal, although indirectly. if entities go bankrupt, there would be insufficient proper mediacl attention. And notice, it would not be for lack of skilled and available doctors. It would all be about 'money'.)

"Quite frankly, that's our biggest single concern at this point," said Gene Eberhardt, Medicare coordinator for Portland-based Medicare Northwest, which processes more than 1.5 million hospital claims a year in Oregon, Washington and Idaho. "We and HCFA have really grave concerns about what will happen if they cannot submit those claims."

HCFA, the Health Care Financing Administration, is the federal agency that oversees the Medicare and Medicaid programs. The agency has warned doctors and hospitals that it will not make payments on improperly submitted claims.

Oregon and Washington doctors generally file Medicare claims through Noridian Government Services, the Medicare contracting arm of Blue Cross Blue Shield of North Dakota. About 77 percent of all Noridian's claims are filed electronically.

As of Nov. 5, Noridian had completed tests with only 92 medical clinics, billing services, clearinghouses and vendors that file Medicare claims in Oregon, Washington and four other states. Those 92 clinics and businesses file about 17 percent of the total number of claims Noridian receives each year.

"There hasn't been any federal end-to-end testing that I'm aware of," said Ronald W. Schumacher, OHSU's chief information officer.

Along with other Y2K project chiefs, Schumacher said he hadn't been contacted by the federal government about the need to conduct joint Medicare tests.

To overcome the information gap, the Health Care Financing Administration has launched an all-out, 11th-hour effort to persuade doctors to test their systems.

Steve Woodward

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What does 'bleak diagnosis' sound like to you? A reason for optimism based upon the facts and evidence?

Yes, this sounds like a properly managed remediation. All is well with fifty days to go.

http://www.oregonlive.com/business/99/11/bz111202.html

--

Paul Milne

"If you live within 5 miles of a 7-11, you're toast"

--

-- snooze button (alarmclock_2000@yahoo.com), November 16, 1999

Answers

Making sure that my parents are fully up-to-date as possible on their medical visits. Since this is happening late in the year, perhaps the insurance payments won't be processed in time, but at least they won't have been refused care.

-- Brooks (brooksbie@hotmail.com), November 16, 1999.

If there is water, heat, light and food, then the elderly will do fine and doctors and hospitals will continue to care for them.

However, doctors and hospitals will NOT GET PAID for about 30% of the care they give next year. Who's going to eat the float? They are. Even if Y2K is a 2, look for more consolidation in the industry and many more hospitals closing.

-- nothere nothere (notherethere@hotmail.com), November 16, 1999.


OK, let's dig out all the gov PR that tells us that Medicare is compliant and that Y2K has already happened. Quick, quick, before I need to file a claim.

-- Where are they when you need 'em? (Calling@The.Hoffy.Polly), November 16, 1999.

Here is a site to keep your eye on.

HCFA National Y2K Testing Week Nov15-Nov19

While you are waiting for the results, check out the results from prior tests. Note that in the October 1999 Nationwide test, while they claim only 3% critical failures, approximately 1 in 3 claims failed to be processed. Additionally, human error was responsible for almost as many claim failures as the buggy code.

Testing Experience



-- Pete (pberry1_98@yahoo.com), November 16, 1999.


Guess what mister president? We know a young family with 9 year old twins and a 7 year old brother. All three of these children have CF. Mom isn't able to work as she plays full-time nurse to her three young children and Daddy must be careful not to make too much money or they will loose ESSENTIAL benefits that are keeping these children alive.

Medicare? Y2K? Three day storm? Don't panic, we've got this under control?

Kiss my ass President Clinton. Your criminally negligent handling of this crisis is about to kill three kids. I don't even care to discuss how many others, 'cigar boy'.

Have rope, will travel?

-- Will continue (farming@home.com), November 16, 1999.



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