CIO worried Medicare providers not ready for Y2K

The top information technology official for the Health Care Financing Administration, which oversees the nation's Medicare program, told Congress last week that he has serious concerns about whether the Medicare program will avoid Year 2000 problems.

The top information technology official for the Health Care Financing Administration, which oversees the nation's Medicare program, told Congress last week that he has "serious concerns" about whether the Medicare program will avoid Year 2000 problems.

Gary Christoph, the chief information officer for HCFA, told a joint hearing of two House panels that even though the agency has repaired all of its internal computer systems for the computer glitch, some of the third-party Medicare contractors and health care providers are behind in fixing their computers.

"We continue to have serious concerns about the readiness of...Medicare providers," Christoph testified.

HCFA manages health insurance for about 39 million people and processes more than $280 billion in health claims annually. Smooth operation of the claims process after Dec. 31, 1999, will depend on HCFA's internal computer systems as well as those operated by third-party Medicare contractors and health care providers, according to witnesses testifying before the two House subcommittees overseeing the Year 2000 computer problem.

Joel Willemssen, director for civil agencies information systems issues at the General Accounting Office, told the subcommittees that HCFA continues to test how well it exchanges data with its contractors, in some cases uncovering errors that would cause serious problems.

The full extent of Year 2000 problems involving providers that give care to Medicare recipients remains unknown. Less than 2 percent of 230,000 hospitals, nursing homes, doctors and other health care providers who submit claims to Medicare had tested their computer systems with Medicare contractors, said Rep. Stephen Horn (R-Calif.), chairman of the House Government Management, Information and Technology Subcommittee. Horn's subcommittee met jointly with the House Science Committee's Technology Subcommittee.

HCFA officials have been working to "recertify" that their internal computer systems are Year 2000-compliant. The recertification follows routine maintenance and upgrade of the systems, Christoph said. He also said the agency needs to recertify its systems following congressionally mandated changes to the Medicare program, which required the agency to reprogram some of its systems to deal with the changes.

Willemssen said HCFA should try to test all of its critical computer systems as it works to recertify them. HCFA has set Nov. 1 as the deadline to have all of its mission-critical systems ready. The tight deadline has made it difficult for the agency to conduct integrated tests involving all of its key systems, Christoph said.

Many health care providers have been slow to respond to HCFA's inquiries on their Y2K readiness, hindering the agency's efforts to test the entire Medicare business process—from the health care provider to the federal government. Christoph called the situation "frustrating."

Fred Brown, chairman of the board of trustees of the American Hospital Association, testified that the hospital sector has been preparing diligently for the problem, and that it "will be ready for Y2K." He said hospitals will spend close to $8 billion to become Year 2000-compliant, with most of that money being spent this year.

Whitney Addington, president of the American College of Physicians-American Society of Internal Medicine, said his organization recently has finished an awareness campaign but said he remained concerned that some physicians may rely too much on vendors for Y2K compliance.

"ACP-ASIM is very concerned therefore that too many physicians may be relying on vendor certifications that the vendor's software is Y2K-compliant," he said. "While we think it risky for nonexperts to try rolling forward the dates on computer systems to determine their Y2K readiness. It is imperative that even new systems, as well as those supposedly corrected for Y2K, be tested by experts."

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