Cms Sends Christmas Present to U.s. Computer Programmers

Posted by Law Article on July 18th, 2009 at 08:55pm

The Baltimore-based Centers for Medicare and Medicaid Services (CMS) is playing Santa Claus to U.S. software programmers this year. New CMS rules implementing the Mandatory Insurer Reporting law (Public Law 110-173) passed by Congress late in 2007 will require thousands of U.S. insurers and self-insured companies to engage software programmers to make big changes to the complex computer programs by which workers’ compensation, liability, no fault and group health claims are administered.

The MIR law requires all U.S. companies that insure or self-insure workers’ compensation, liability, no fault and group health claims to begin reporting data on all claims involving Medicare beneficiaries during 2009. That reporting will be electronic-only and will require factual information that most of the thousands of existing claims handling systems do not current capture.

Reporting entities will need, for example, to tell the feds about each Medicare beneficiary’s injury – including medical diagnosis, body part involved and cause of injury. The medical diagnosis must be reporting using the International Statistical Classification of Disease (ICD-9) codes. The body part and cause of injury information must be reporting using the Workers Compensation Insurance Organization (WCIO) codes. A vast majority of existing claim systems do not currently capture ICD-9 or WCIO codes.

According to the U.S. Bureau of Labor Statistics the job prospects of computer programmers has been declining in recent years. But with all the thousands of claim systems that will need to be reprogrammed quickly to meet the new CMS reporting requirements, those prospects have to looking a lot better for the near future.

For more information on MIR and CMS requirements under the new law, visit www.gullenlaw.com or contact Chris Gullen at chris@gullenlaw.com.

Tags: Cms, Medicare