Administrative Simplification Compliance Act (ASCA)

On April 15, 2002, the Department of Health and Human Services (HHS) Centers for Medicare and Medicaid (CMS) published the 26-question HIPAA Model Compliance Extension Form, which could be used by covered entities to request a one-year extension to the October 16, 2002 compliance date for standard transactions and code sets.

Covered entities were required to submit an electronic compliance plan for an extension by October 15, 2002; paper submissions were to be postmarked by that same date. A covered entity did not have to file a compliance plan if it was going to be compliant with the transactions rule by October 16, 2002, even if its trading partners were not compliant.

On August 15, 2003, HHS published the Interim Final Rule for Electronic Submission of Medicare Claims. This rule implements the statutory requirement found in ASCA. ASCA requires (with a few exceptions) all claims sent to the Medicare Program be submitted electronically starting October 16, 2003. This Rule sets forth the details for implementation of the Medicare electronic claims submission requirement and who may be exempt from these requirements.

The regulation requires that all claims submitted to Medicare on October 16, 2003 and beyond be done so electronically except for certain circumstances including: