HCFA Is Helping Health Care Providers Prepare for Y2K

ALEXANDRIA, Va—The Health Care Financing Administration (HCFA), the federal agency that pays Medicare claims, expects to be doing business as usual on January 1, 2000, and beyond despite Y2K, said Joseph Broseker, Jr., Y2K Coordinator at the HCFA headquarters, Baltimore.

The Y2K problem threatens to cause computers around the world to malfunction when they must deal with dates at the beginning of the 21st century. However, the giant agency is confident that it will fill claims “as well as we do today,” Mr. Broseker assured a plenary session at the 25th Annual Meeting of the Association of Community Cancer Centers (ACCC).

“No matter how well we’re able to pay claims, we can’t pay them if we don’t receive them,” he continued, expressing concern that many health care providers do not appear to be making adequate preparations. In fact, HCFA now requires that claims use a new date format in which the year consists of four digits rather than two. Since April 5, claims filed without the new format have been returned as unprocessed.

“HCFA is concerned,” he said, “about providers’ ability to give care if computer problems prevent them from receiving timely reimbursements.” After spending $100 million last year and the same amount this year to prepare its own computers, the agency has also taken an unprecedented program to prepare health care providers to be able to continue submitting claims, he said.

HCFA has already mailed individual letters to more than 1.3 million health care providers across the nation, warning them of the looming problem and informing them of resources to help them make their systems Y2K compliant.

Informational Conferences

It has also, in cooperation with the Small Business Administration, scheduled a series of informational conferences at various locations across the country on the potential effect of Y2K on medical devices, pharmaceutical supplies, and HCFA services. These meetings will also discuss Small Business Administration loans that are available to help defray the cost of making systems Y2K compliant.

Local-level learning sessions will also take place in a number of locations convenient to rural providers in various parts of the country. Information is available at www.hcfa.gov or by telephoning 1-800-958-HCFA.

“There is time to do a lot yet,” Mr. Broseker said, explaining the steps that HCFA has taken to make its systems Y2K compliant. “We had an enormous problem with huge amounts of outdated computer code,” he said. HCFA has updated and tested for Y2K compliance almost 100 mission-critical computer systems. “Without these, we would fail our mission,” he said.

Medicare systems involve more than 50 million lines of code, 70 Medicare contractors, more than 400 managed care organizations, and thousands of data exchange partners. At present, 200 federal employees are working full-time to test HCFA’s systems. In addition, an independent contractor has also tested and verified HCFA’s Medicare claims processing system.

Because of the enormous size of the task, the agency has had to delay other work in order to have the resources to prepare for Y2K. The agency’s Administrator, however, made uninterrupted service the top priority, Mr. Broseker said.

All of the agency’s internal systems are now Y2K compliant, and most of these are already in operation under their new formats, he said. More than two thirds of the agency’s internal systems met a December 31, 1998, deadline for compliance, and nearly all of the rest did so by March 31, 1999. HCFA will also check to see if various managed care systems are also prepared.

“Any health care organization will face some of the same list of problems that confronted HCFA,” he said. He cautioned that, come the year 2000, HCFA will not provide advance payments to tide providers over in case their billing systems fail.

Software Vendors’ Concerns

Mr. Broseker also noted that software vendors have expressed concern that large numbers of health care providers do not seem to be ordering Y2K-compliant versions of crucial software programs. The suppliers fear being overwhelmed with customer demand, and unable to provide service to customers in trouble, as the year 2000 approaches.

“Newly purchased off-the-shelf software may take some time to adapt,” Mr. Broseker warned, and in some cases will require new hardware, which will cause even longer delays. He emphasized the importance of providers talking with their suppliers of computer systems, as well as those who provide and service their medical devices, to see which equipment needs testing and how, if necessary, it can be made Y2K compliant.