November 2005 News Archives

November 30, 2005 AHA Cites Concerns About Claims Attachments Proposed Rule A proposed rule establishing standards for attachments to electronic health claims presents unreasonable costs and fails to address important issues, the American Hospital Association told the Centers for Medicare & Medicaid Services (CMS), reports AHA News. In its comments to CMS on the HIPAA Electronic Health Care Claims Attachments Notice of Proposed Rule-Making (NPRM), AHA said the proposed standards introduce several elements not commonly used in current billing processes, requiring hospitals to make costly investments that yield no return. Moreover, AHA said, the rule does not establish a formal communication process between providers and health plans so that hospitals can be notified when claims are delayed pending the submission of additional information. AHA asked CMS to issue rules for the adoption of ICD-10, a new coding classification system that provides greater specificity for diagnosis and procedure reporting as well as mortality data from death certificates, prior to finalizing the attachments rule. The ICD-10 classification system has the ability to reduce or eliminate the reliance on claim attac hments, the association noted. AHA also urged a contingency period of at least three years after the final rule is issued to allow hospitals time to budget, train staff and conduct testing with trading partners.

Read AHA's comment letter (PDF).

November 29, 2005 CMS Seeks Opinions on New Medical Data System The Centers for Medicare and Medicaid Services (CMS) is seeking opinions on a new data collection and record-keeping initiative to track medical care during a national disaster, reports Health Data Management. On November 23, CMS published a notice in the Federal Register on its proposed National Disaster Medical System Claims Processing System. "The primary purpose of the system is to justify and document payments for inpatient hospital and related practitioner services provided in connection to the National Disaster Medical System," according to the notice. The system will collect patient-identifiable information and, under HIPAA, CMS' policy will be to "prohibit release even of data not directly identifiable, except pursuant to one of the routine uses or if required by law, if we determine there is a possibility that an individual can be identified through implicit deduction based on small cell sizes (instances where the patient population is so small that individuals who are familiar with the enrollees could, because of the small size, use this information to deduce the identity of the beneficiary)."

Read more.

November 29, 2005 NCVHS Submits Comments on Claims Attachments NPRM On November 22, the National Committee on Vital and Health Statistics (NCVHS), a public advisory committee to the US Department of Health and Human Services (HHS), submitted its comments to Secretary Leavitt on the Claims Attachment notice of proposed rule-making (NPRM) which was published September 23, 2005. In its letter, NCVHS supports the proposed standards and also recommends flexibility for adopting new standards and additional types of attachments. NCVHS recommends the development of a streamlined process for adding new standards and attachments types and for modifying existing standards, without the lengthy and cumbersome rulemaking process. NCVHS also recommends that pilot projects should be funded and conducted for the claims attachments and attachment types that are proposed for adoption in this NPRM, as well as the other attachments that are under development. NCVHS concludes its letter by noting the 60-day extension of the comment period which will allow the industry more time to comment on the business and technical implementation issues associated with the standards proposed in the NPRM.

Read NCVHS' comment letter.

November 21, 2005 HHS Extends Comment Period for Claims Attachments Proposed Rule Today the Department of Health and Human Services (HHS) displayed notice of a 60-day extension to the comment period for the proposed rule entitled, “HIPAA Administrative Simplification: Electronic Health Care Claims Attachments.” The notice will be published tomorrow in the Federal Register. The public comment period will now close on January 23, 2006. Due to the highly technical nature of materials, the size (length) of the 10 documents being reviewed, and the importance of ensuring their accuracy and usefulness to the industry, HHS is providing additional time for review and comment. During the initial comment period, the industry requested additional time to conduct a more comprehensive and through review of the proposed standards, in order to provide comments to HHS and to the Standards Development Organizations (SDOs).

November 17, 2005 JCAHO Steps Back on Data Analysis Sales The Executive Committee of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has told the American Hospital Association (AHA) that it will recommend to the JCAHO Board of Commissioners at their meeting this week that the Joint Commission should not engage in the sale of data analysis to third parties, reports AHA News. The Committee indicated that the Joint Commission should collaborate with hospital leaders to achieve the most effective and acceptable use of JCAHO-based hospital information. AHA, in a bulletin to hospitals, said it appreciates the Joint Commission’s response to the concerns of hospital leaders and looks forward to continued work together to improve the quality and safety of care.

Read JCAHO's statement regarding the use of performance data.

November 15, 2005 Report: Federal Actions Can Discourage IT Implementation A new market research report, "The US Market for Clinical Information Systems" focuses on hospital acquisition of clinical IT, which it says will account for more than $25 billion of the total in 2009, reports Government Health IT. Kalorama Information, a division of MarketResearch.com, published the report. Describing actual and potential federal programs to promote health IT use, the report cites HIPAA as an example of how federal actions can also discourage implementation. "The HIPAA transaction rules require investments in IT supporting transactions, potentially at the expense of other investments," the report states, adding, "The HIPAA privacy and security requirements may also increase the complexity of the design of IT systems that share patient information."

Read more.

November 15, 2005 OCR Bars EMS Ride-Along Program Over Privacy Concerns The Department of Health and Human Services' (HHS) Office for Civil Rights (OCR), Region 3, citing privacy concerns for patients, issued a letter October 11 informing THE District of Columbia's Fire and Emergency Medical Services (EMS) Department to either scrap its ride-along program within 30 days or submit plans to alter the existing program, reports the Washington Times. According to the letter, "disclosures of protected health information to persons other than healthcare providers, as would occur in the context of a ride-along program, would require an authorization of the individual or their personal representative." The letter also states, "The fact that [the DC Fire and Emergency Medical Services Department] has no way of knowing in advance which individuals will be treated or transported effectively precludes obtaining prior authorization of disclosure." An official with HHS could not discuss whether the letter was meant to set a national precedent, but said it was part of an investigation into whether the city violated the provisions of HIPAA.

Read more.

November 11, 2005 Group Soliciting Survey Participants About Post-HIPAA Privacy Policies ThePrivacyPlace.Org, a non-profit North Carolina State University research group, is soliciting survey participants for its 2005 Privacy Survey about privacy policies and user values, including post-HIPAA privacy policies from healthcare web sites. The survey is supported by a National Science Foundation Information Technology Research grant. The survey takes about 10 minutes and once completed, you will have the chance to enter a drawing for a prize, such as a $50 Amazon.com gift certificate or IBM-sponsored giveaway. Survey results will be made available in 2006 at ThePrivacyPlace web site.

Take the survey.

November 10, 2005 Another High-Profile Breach As House Committee Approves Data-Protection Bill TransUnion LLC, one of the three major credit reporting companies in the US, yesterday confirmed that a desktop computer containing the Social Security numbers and other sensitive information belonging to more than 3,600 consumers was stolen from one of its facilities in October, reports Computerworld. The implications of the reported breach could go beyond the customers whose data was stolen if information stored on the missing desktop enables access to databases holding information on other consumers. The TransUnion breach is the latest in a series of high-profile data compromises this year. The rash of disclosures has raised consumer concerns about identity theft and prompted federal lawmakers to propose several new regulations.

Last week, a subcommittee of the House Energy and Commerce Committee approved a bill that would require information brokers to submit plans for safeguarding private data to the Federal Trade Commission for monitoring and review, reports the Washington Post. The bill also would establish the first nationwide requirement for notification of consumers when certain breaches of data occur and would force brokers to submit to security audits if their data banks are compromised. Under the bill, data brokers and other firms that store consumer data would have to notify consumers that their information was breached only when it was determined that a "significant risk" of identity theft or other fraud might result.

Read Computerworld's article, "TransUnion Notifies Consumers of Data Loss."

Read the Washington Post's article, "Parties Split on Data-Protection Bill."

November 10, 2005 OCR Offers Guidance on Identifying Dually Eligible Medicaid/Medicare Enrollees The Department of Health and Human Services' (HHS) Office for Civil Rights has posted a new Frequently Asked Question (FAQ) on its web site. The FAQ addresses the sharing of protected health information (PHI) under the HIPAA Privacy Rule between a State Medicaid agency and a Medicare Advantage plan for purposes of identifying dually eligible enrollees.

Read OCR's FAQ.

November 10, 2005 Survey Finds Consumer Health Privacy Concerns Despite new federal protections, 67 percent of Americans remain concerned about the confidentiality of their personal health information and are largely unaware of their privacy rights, according to the National Consumer Health Privacy Survey 2005. The survey, released this week by the California HealthCare Foundation (CHCF), also found that a majority of consumers are concerned that employers will use their medical information to limit job opportunities. A follow-up to CHCF's 1999 health privacy study, the new survey, conducted by Forrester Research, explores consumer attitudes about confidentiality issues in the wake of implementation of national privacy protections under HIPAA and the President's push to adopt electronic medical records.

Read more.

November 10, 2005 Microsoft Lobbies for Federal Privacy Law Microsoft has come out in support of a single federal consumer privacy statute, reversing an earlier position, saying that there are too many privacy provisions in other laws and they are hampering American business, reports Computer Business Review Online. In a speech and white paper issued last week, Microsoft general counsel Brad Smith said a "bewildering jumble of overlapping state and federal laws" is creating consumer confusion and "major challenges for businesses trying to comply". Currently, organizations in certain vertical markets in the US have to worry about the privacy implications of legislation such as Gramm-Leach-Bliley and HIPAA, as well as laws not specific to certain markets, he said.

Read more.

November 7, 2005 HHS Publishes Semi-Annual Regulatory Agenda The Department of Health and Human Services (HHS) on October 31 published its semiannual regulatory agenda, a summary of rulemaking actions under development or review by the department. Several will affect HIPAA requirements and efforts to build a national health information network:

• A final HIPAA enforcement rule, expected in February 2006.
• A notice, for publication in February 2006, describing the data that will be available from the National Plan and Provider Enumeration System.
• Two final rules, expected in March 2006, establishing a shared risk exception and a safe harbor under the federal anti-kickback statute for certain electronic prescribing initiatives.
• A proposed rule, expected in May 2006, to modify some of the electronic transactions and code sets mandated by HIPAA.
• A proposed rule, expected in June 2006, to establish a standard unique national health plan identifier under HIPAA to identify health plans that process and pay certain electronic healthcare transactions.
• A proposed rule, expected in September 2006, would revise some of the adopted transactions and code sets.
• A final rule, expected in December 2006, to implement requirements for electronic submission of Medicare claims and conditions upon which a waiver could be granted.
• A final rule, expected in September 2008, to establish an electronic standard for claims attachments. It will be used to transmit clinical data, in addition to the data contained in the claims standard, to help establish medical necessity for coverage and payment.
• A final rule, expected in October 2008, to create an exception to the physician self-referral prohibition for certain electronic prescribing initiatives.

Keep up-to-date on the status of the HIPAA regs with our Compliance Calendar.

November 4, 2005 AHA Requests OCR's Guidance on JCAHO HIPAA Concerns In a meeting yesterday with the Office for Civil Rights (OCR), the American Hospital Association (AHA) requested fast-track guidance to help hospitals deal with HIPAA compliance issues raised by the Joint Commission on Accreditation of Healthcare Organizations' (JCAHO) plans to become a data business, reports AHA News. OCR is the agency within the Department of Health and Human Services (HHS) specifically responsible for HIPAA enforcement. AHA described hospitals' concerns over JCAHO's plans to seek patient level data from accredited hospitals and use the data in ways unrelated to accreditation. "We stressed to OCR officials that patient privacy should not be treated as an afterthought," said Don Nielsen, MD, AHA's senior vice president for quality leadership. Hospital concerns and precise requests made to OCR are detailed in a legal memo drafted by outside counsel.

Read the memo (PDF).

November 1, 2005 Federal Commission Recommends Patient ID Standard The Commission on Systemic Interoperability, a federal advisory body, recommends in its final report that the government should develop a national patient authentication standard that protects individuals’ information and lead an effort to offer financial incentives to providers in order to foster the electronic exchange of health information. The 250-page report, which was released to the Senate and House of Representatives last week, spells out 14 recommendations that focus on three major areas: adoption issues, interoperability of healthcare data, and secure connectivity between networks. The report calls for a uniform federal health information privacy standard that would overrule state laws that limit or prevent information sharing among authorized individuals and institutions, as well as financial incentives for healthcare providers and the elimination of regulations that could slow the adoption of interoperable electronic health records (EHR). The 11-member body unanimously issued general recommendations for standardizing the diverse systems that identify patients and assemble records. A national ID number would be one way to standardize, the report states.

Read Government Health IT's article, "Commission Recommends Patient ID Standard."

Read Computer World's article, "Federal Commission Looks to Push E-Health Record Adoption."

Read the report at EndingtheDocumentGame.gov.