March 28, 2002

February 25, 2002

January 18, 2002

 

The following is the "official statement" from CMS (formerly HCFA) regarding the signing, implementation and requirements of the Transaction & Code Set implementation delay.

 

On December 27, 2001, President Bush signed into law H.R. 3323, the Administrative Simplification Compliance Act (now known as Public Law 107-105). This law provides for a one year extension of the date for complying with the HIPAA standard transactions and code set requirements (to Oct 16, 2003) for any covered entity that submits to the Secretary of Health and Human Services a plan of how the entity will come into compliance with the requirements by October 16, 2003.

 

The plan must be submitted by October 15, 2002 and shall be a summary of:

 

(A) An analysis reflecting the extent to which, and the reasons why, the person is not in compliance.

(B) A budget, schedule, work plan, and implementation strategy for achieving compliance.

(C) Whether the person plans to use or might use a contractor or other vendor to assist the person in achieving compliance.

(D) A timeframe for testing that begins not later than April 16, 2003.

The law also requires the Department to develop and promulgate a model compliance form for the plan by March 31, 2002, and to allow for compliance plans to be submitted electronically.

Please note that this legislation kept in place the compliance deadlines for the Privacy Rule (April 14, 2003 for all covered entities except small health plans; April 14, 2004 for small health plans).

 

The Department will be providing the details of the model form and submission procedures at a later date.

 

The law also requires that, by Oct 16, 2003, providers stop submitting paper claims and submit claims electronically to Medicare. There are waivers for certain small providers or if there is no method for electronic submission of claims available. CMS will provide further details about these requirements through the regulatory process.

 

You can read the enrolled version of the bill (the version passed by Congress) at:

http://thomas.loc.gov/cgi-bin/query/z?c107:H.R.3323.ENR:

The Public Law version is expected to be available at the Government Printing Office shortly.

 

Stanley Nachimson

Office of Information Services, CMS

410-786-6153

 

DON'T FORGET TO REGISTER FOR THE JANUARY WORKGROUPS SESSIONS COVERING MINIMUM NECESSARY AND SECURITY ISSUES. WE HAVE ALSO ADDED A FOURTH SESSION IN NEW ORLEANS. A DETAILED OUTLINE AND BIOGRAPHIES OF THE SPEAKERS HAVE BEEN ADDED TO THE WEBSITE. CALL OR EMAIL US IF YOU HAVE ANY QUESTIONS.

DON'T FORGET THE HIPAA SECURITY & ACCESS WORKGROUPS SESSIONS.

 

HR 3323, which was signed by President Bush at the end of last year, delays the effective date of the Transaction & Code Set regulations for one year. The following is an excerpt from the published legislative history that makes it clear that the legislation does not delay the privacy compliance deadline. We will publish the entire statement on the website in the next few days.

 

"Mr. Thomas, on behalf of himself, Mr. Rangel, Mrs. Johnson, Mr. Stark and Mr. Hobson inserted the following comments in the Congressional Record of December 20, 2001 regarding H.R. 3323.

Legislative History and Intent Concerning H.R. 3323, the Administrative Simplification Compliance Act.

Background and Need For Legislation

The administrative simplification provisions of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 will improve administrative efficiencies in the health care market by facilitating electronic transactions between covered entities-health plans, clearing houses and health care providers. Indeed, the Department of Health and Human Services estimated that administrative simplification will save $29.9 billion over 10 years as a result of increased efficiencies.

Many covered entities believed coming into compliance with the October 16, 2002 deadline set by the regulations implementing the transactions and code set standards required by HIPAA was an insurmountable hurdle. As such, they argued that a one-year delay in implementing the transactions and code set standard was necessary.

* * *

Scope and Application of Confidentiality Rule

In this legislation, the Committee has sought to ensure that entities become compliant with the April 14, 2003 HIPAA confidentiality requirements despite the fact that the final transaction standards will not be effective until six months later. With regard to clearinghouses, the Committee appreciates that there are healthcare information technology vendors, such as applications service providers (ASPs) that create, adjudicate and process claims in other ways than converting data into standard transactions formats other than HIPAA standardized formats. The Committee does not intend to create any new covered entities under any of the HIPAA rules during this time.

The Committee does not intend to modify the April 14, 2003 effective date of the confidentiality regulation in this legislation.

* * *

Completion of Additional Rules

The Committee strongly encourages the Department of Health of Human Services to complete in final form, the outstanding rules provided for in the original statute, namely the provider identifier, plan identifier, and employer identifier. Congress also strongly encourages the Department to issue the final security and electronic signatures regulation.

 

DON'T FORGET TO REGISTER FOR THE JANUARY WORKGROUPS SESSIONS COVERING MINIMUM NECESSARY AND SECURITY ISSUES. WE HAVE ALSO ADDED A FOURTH SESSION IN NEW ORLEANS. A DETAILED OUTLINE AND BIOGRAPHIES OF THE SPEAKERS HAVE BEEN ADDED TO THE WEBSITE. CALL OR EMAIL US IF YOU HAVE ANY QUESTIONS.

It was reported that HR 3323 was signed by the President last Thursday, December 27.  It is now official - the Transaction & Code Sets compliance date has been moved back one year.  The first HIPAA rule to go into effect will now be the Privacy rules.

Happy New Year!

The Society for Healthcare Strategy and Market Development of the American Hospital Association recently released the latest edition of its "Guidelines for Releasing Information on the Condition of Patients." This short publication was revised to comply with the directory provisions in the "opt-out" section (§510) of the HIPAA Privacy Rules. It can be accessed (at no charge) at http://www.stratsociety.org/resources/rc_315.doc .

 

Those who attended the last WorkGroups sessions (Authorization and Opt-Out) will find it particularly interesting. It will be a good starting point for an effective policy on the subject.