ENTERPRISE COMPUTING | Beat the Clock

| Beat the Clock


HCFA
started in earnest only a year ago to make year 2000 fixes, and for months it has
weathered the scorn of year 2000 congressional watchdog Rep. Steve Horn (R-Calif.). Last
month, HCFA officials told Congress that work on mission-critical systems is 70 percent
complete.


“Renovating these systems has been complicated,” HCFA administrator Nancy-Ann
DeParle testified. Her agency pays for the health care of more than 70 million Medicare,
Medicaid and Children’s Health Insurance Program beneficiaries. It processes 1
billion claims annually.


The cost of readying the automated processing systems has been high largely because of
their complexity, said Gary Christoph, director of the Office of Information Services. The
agency’s 100-plus systems have 250,000 interfaces to state Medicaid programs, banking
institutions and health providers.


Such systems are dotted with critical dates—beneficiary eligibility dates,
hospital admission and discharge dates, start and stop dates for such things as wheelchair
rentals, and patients’ managed-care enrollment dates.


Rigorous to a fault. HCFA had to renovate 49
million lines of internal and external Cobol code. Its year 2000 testing has been the most
rigorous in the agency’s history, Christoph said.


He cited instances of putting 36,000 test cases through a claims processing system
reset for multiple future dates. Even HCFA’s smallest claims processing system has 2
million lines of code. Christoph said he is sure HCFA systems have been tested “above
and beyond what industry is doing.”


DeParle told Congress she worries now that states, banks and care providers will not
have their systems ready in time. The agency is concerned enough to have spent several
million dollars on independent validation contractors to check up on readiness. Recent
General Accounting Office surveys and HCFA’s own independent verification efforts
indicate that some states may have systems problems after Jan. 1.


Clean claims. To protect its renovated
systems, HCFA has notified all claims submitters—physicians, hospitals and other
institutions—that after April 5 it will not accept any bills submitted without year
2000-ready electronic data interchange formats.


HCFA is going to great lengths to maintain its public services. The agency in January
mailed a year 2000 checklist to the nation’s 1.3 million health care providers to
reiterate what they must do.


—Florence Olsen
folsen@gcn.com





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