U.S. Department of Health & Human Services (HHS) Secretary Mike Leavitt proposed the adoption of standards for certain attachments to electronic healthcare claims, a requirement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
The proposed standards, published in the Federal Register, will apply to electronic transactions by covered entities to request and provide clinical information for certain types of services which are being billed by the provider to the health plan.
Covered entities will be required to use the standards when they are conducting an electronic transaction for the purpose of requesting and providing additional information for one of the six types of services.
"These HIPAA provisions make processing claims and other healthcare transactions much more efficient and in the long run save millions of dollars," Secretary Leavitt said. "Adoption of these standards and the implementation of electronic medical records will allow our healthcare community to lead America's efforts in improving the quality of care, avoiding errors and enhancing communication between providers."
These electronic healthcare claims attachment standards have been designed to work in concert with the HIPAA Privacy Rule, published in the Federal Register on December 28, 2000, as modified by changes published on August 14, 2002, and the HIPAA Security Rule, published in the Federal Register on February 23, 2003, as well as the HIPAA Transactions and Code Set Rule, published in the Federal Register on August 17, 2000, and modified February 20, 2003. The proposed standards would use much of the same terminology and definitions.
This proposed rule has a 2-month comment period, which ends November 23, 2005. When adopted in a final rule, the attachment standards will affect healthcare providers who transmit health information in electronic form in connection with a transaction covered by HIPAA, health plans, and healthcare clearinghouses, within 2 years (3 years for small health plans) of the effective date of the final rule planned for 2006.
"Setting standards for electronic attachments for the healthcare claims is a natural step in our goal of ensuring that clinical information be available when it is needed," Secretary Leavitt said. "These steps lead to a future in which electronic health records are complete and electronic medical record systems are beneficial."
The proposed standards would require covered entities to use certain transactions, messaging standards, and a new code set when they electronically request the additional information, and provide the information in response to the request. Six specific types of attachments are covered by this proposed rule: laboratory results, emergency department services, ambulance services, medications, clinical reports, and nine rehabilitation specialties.
This article was prepared by Medical Devices & Surgical Technology Week editors from staff and other reports. Copyright 2005, Medical Devices & Surgical Technology Week via NewsRx.com.
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