Text of the American Hospital Association Letter
Opposing Delay of Transaction Standards
September 26, 2001
The Honorable William Thomas
Chairman, House Ways and Means Committee
2208 Rayburn House Office Building
Washington DC 20515
Dear Chairman Thomas:
We appreciate that Congress is appropriately focused on the aftermath
of the September 11 tragedy. We offer this letter for your consideration
at the appropriate time.
The undersigned organizations, representing a broad spectrum of
the nation's hospital community, are concerned about any legislation
to delay the administrative simplification requirements under section
1176 of the Health Insurance Portability and Accountability Act
of 1996 (HIPAA). The legislation, S. 836 and H.R. 1975, specifically
would delay the electronic transactions standards and related requirements,
other than medical privacy, until 24 months after all required regulations
had been issued in final form by the Department of Health and Human
Services (HHS). Since, to date, only the electronic transactions
standards and medical privacy regulations have been issued in final
form, the delay imposed under S. 836 and H.R. 1975 effectively would
be open-ended.
Any legislative delay of the electronic transactions standards
would unfairly penalize hospitals and health systems that have made
the significant commitment of financial and staff resources necessary
to meet the current October 2002 compliance deadline for those requirements.
In enacting HIPAA, Congress deliberately sought predictability and
ways to reduce the costs and burden of meeting the widely different
health care claims form and content requirements of many different
payers. According to HHS, there are some 400 different formats for
electronic claims processing. HIPAA's electronic transactions standards
are intended to standardize these formats and thus significantly
reduce hospitals' administrative burden over time.
Because of their potential for long-term efficiencies and cost
savings, Congress should not delay the electronic transactions standards
beyond the October 2002 compliance date.
Specifically:
- Such a delay would not appear even to be necessary for health
plans; the HIPAA statute itself provides that small health plans
(as defined by the Secretary) have an additional year (until October
2003) to be in compliance with the electronic transaction standards.
- To the extent that some hospitals need additional time to comply,
whether because of financial or practical difficulties, HHS can
and should use its enforcement discretion to effectively grant
delays tailored to the circumstances of individual or similarly
situated hospitals. This is similar to the approach recommended
by one of the Secretary's HIPAA advisory bodies-the National Committee
on Vital and Health Statistics (NCVHS)-in its June 29, 2001 letter
to the Secretary.
We recognize the concern that financial pressures, or practical
difficulties in making necessary modifications to their information
systems, could impede some hospitals' ability to fund or otherwise
attain full compliance with the electronic transactions standards
by October 2002. However, those concerns are best addressed by HHS
through a carefully considered policy to grant hospitals tailored
compliance flexibility with the electronic transactions standards.
The nation's hospital community strongly urges that HHS and Congress
work together to develop an administrative policy that provides
appropriate incentives for the entire health care field to expedite
implementation of the electronic transactions standards, and that
allows flexibility for those hospitals that might need some additional
time to achieve full compliance by the October 2002 deadlines.
If you have any questions about this letter, please contact Melinda
Hatton, Vice President and Chief Washington Counsel for the American
Hospital Association at (202) 626-2336.
Sincerely,
American Hospital Association
Association of American Medical Colleges
Cleveland Clinic Foundation
Federation of American Hospitals
Premier, Inc.
VHA Inc.
CC: Senate Finance Committee
Senate Health, Education, Labor and Pensions Committee
House Ways and Means Committee
House Energy and Commerce Committee
Tommy Thompson, Secretary, Department of Health and Human Services
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