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September 2005 News ArchivesSeptember 28, 2005 CMS Tutorial Explains NPI Transition Plan The Centers for Medicare and Medicaid Services (CMS) has published a six-page tutorial entitled, Medicare’s Implementation of the National Provider Identifier (NPI). The tutorial, the second in a series of special edition Medlearn Matters articles on NPI-related activities, includes a previously announced transition plan for migrating to the identifier. The information covered in the tutorial affects providers and suppliers who conduct HIPAA standard transactions, such as claims and eligibility inquiries, as well as organizations and associations that represent providers and plan to obtain NPIs for those providers. September 27, 2005 WEDI to Conduct Claims Attachments Policy Advisory Forum The Workgroup for Electronic Data Interchange (WEDI) will conduct a Claims Attachments Policy Advisory Group (PAG) Forum on October 25-26, 2005 in Chicago at the Hilton O'Hare. The cut-off date for registering at the WEDI rate of $189.00 is Friday, October 14, so be sure to register as soon as possible. WEDI anticipates that attendance will be heavy for this important program and encourages early registration. WEDI will be soliciting feedback from the industry related to the proposed regulation for claims attachments standards. The PAG will serve as a forum for discussion of regulation-related comments. Ultimately, the comments discussed and recommended by the attendees at the PAG will form the basis for WEDI's official response to HHS as it relates to this Notice of Proposed Rule-Making (NPRM). In order to help attendees prepare for participation in an informed discussion, WEDI will be holding a claims attachments educational session on the morning of Tuesday, October 25th. This session will be especially helpful to those individuals who feel they have a need for more background on the Claims Attachments issues and technical aspects. The actual PAG will begin after lunch that same day and run through the late afternoon of the 26th. Please be sure to have already read the NPRM, as well as several additional documents (whitepaper, FAQ and PAG discussion document) that will be provided to all registered attendees approximately one week prior to the PAG. The fee for WEDI members is $325 and for non-WEDI members is $425. The fee for the PAG educational session is $50. View the program information and registration details. September 27, 2005 KatrinaHealth.org to Provide Evacuees' Electronic Drug Data A public-private ad hoc group has launched KatrinaHealth.org, a secure online service for authorized health professionals to gain electronic access to prescription medication records for Hurricane Katrina evacuees, reports Government Computer News. KatrinaHealth.org will give a single point of access to authorized health professionals and pharmacies to the Hurricane Relief Prescription Network, which contains evacuees’ medication and dosage information in order to renew prescriptions, prescribe new medications, and coordinate care. This information will be accessible to physicians treating evacuees from anywhere in the country. David Brailer, National Coordinator for Health IT in the Department of Health and Human Services, brought together the effort to create KatrinaHealth.org and make it available quickly to healthcare professionals. Within two weeks, physicians in shelters began testing the system. The web site points out, however, that the fact KatrinaHealth.org was not available immediately underscores the need for open, common standards for health interoperability in the US, and reinforces the importance of current public and private activities to achieve the ability to exchange health information electronically. Although there are no current plans to expand KatrinaHealth.org to include other medical information, Brailer said his office would conduct an after-action analysis to determine the site’s effectiveness and how it could be used in the future. September 27, 2005 Private Practices & Unauthorized Use of PHI Still Top OCR's 15,000 Privacy Complaints At the September 8, 2005 full committee meeting, Linda Sanchez of the Office for Civil Rights (OCR) updated the National Committee on Vital and Health Statistics (NCVHS), an advisory body to the Department of Health and Human Services, on Privacy Rule compliance. As of August 31, OCR has received over 14,900 complaints, 68% of which have been closed. OCR has referred 231 cases to the Department of Justice for criminal investigation. The top entities against which HIPAA complaints have been filed are:
The top allegations, ranked in order, raised most frequently in complaints continue to be:
September 26, 2005 CMS Publishes New Proposed Rule for Electronic Healthcare Claims Attachments On September 23, the Centers for Medicare and Medicaid Services (CMS) published in the Federal Register a proposed rule adopting standards for electronic healthcare claims attachments. Healthcare claims attachments are documents and information, such as physician notes and medical images, required by health plans to adjudicate certain claims. The proposed rule, mandated by HIPAA, adopts two new X12 transaction standards: a Health Level 7 (HL7) messaging standard to carry clinical information in the response transaction and HL7 specifications for the content or “questions” that may be asked in each of the six attachment types. The publication of this proposed rule was a landmark event for the Accredited Standards Committee (ASC) X12 and HL7, whose members have worked collaboratively on these complex standards for electronic claims attachments since 1997. Both the ASC X12 Insurance Implementation Guides and the HL7 specifications can be downloaded free of charge at www.wpc-edi.com. This proposed rule also adopts the Logical Observation Identifiers Names and Codes (LOINC) as a new HIPAA code set to be used to identify the questions and answers (attachment information). The standards allow for the transmission of structured or coded data, as well as images and text. The proposed rule solicits comments from the affected industries on several key issues, including the adoption of LOINC and its use for the HIPAA transactions, the appropriateness of the six proposed attachment types, business requirements for attachments that would accompany the original claim (unsolicited attachments), and the cost-benefit implications of adopting this transaction set. The public comment period is open until November 22. Read the text of the proposed Claims Attachment rule (PDF). September 22, 2005 CMS Delivers VistA-Office EHR Software to Physician Offices The Centers for Medicare and Medicaid Services (CMS) this week released an evaluation version of VistA-Office Electronic Health Record (EHR) to assess its effectiveness in private physicians offices. VistA-Office is an adaptation of the Veterans Health Administration EHR technology. The evaluation version will be distributed by qualified vendors and evaluated for usability, effectiveness, implementation, and interoperability. The VistA-Office evaluation software is not free software. There is a small fee for obtaining the software on computer disk, and there will be other fees an office will need to pay to use the software including licensing and support fees. September 16, 2005 Health Records of Evacuees Go Online The federal government is making medical information on Hurricane Katrina evacuees available online to doctors, the first time private records from various pharmacies and other healthcare providers have been compiled into centralized databases, reports the Washington Post. The data contain records from 150 Zip codes in areas hit by Katrina. Starting September 13, doctors in eight shelters for evacuees could go to the Internet to search prescription drug records on more than 800,000 people from the storm-racked region. Although the immediate focus is on urgent care for hurricane victims, participants in the effort say the disaster demonstrates a broader need to computerize individual health records nationwide and make them available throughout the medical system. September 15, 2005 HHS Extends HIPAA Enforcement Rule The Department of Health and Human Services (HHS) is extending by six months the expiration date of the interim final HIPAA enforcement rule. The interim final rule originally was set to expire on September 16, 2005. Published yesterday in the Federal Register, the regulatory action extends the expiration date to March 16, 2006 to avoid the disruption of ongoing enforcement actions while HHS works to develop a more comprehensive enforcement rule. Read the extension notice (PDF). September 13, 2005 HHS' Free EHR Software is on Hold; Survey Estimates $33,000 per Doc for EHR Systems The release of free electronic health record (EHR) software that physicians could download from the Department of Health and Human Services (HHS) has been delayed indefinitely, reports Government Health IT. Dr. Karen Bell, division director of the Quality Improvement Group at HHS' Centers for Medicare and Medicaid Services, said that VistA-Office "is undergoing a review right now by the secretary's office. VistA-Office, based on the EHR system that the Department of Veterans Affairs developed for use in VA hospitals and clinics, was supposed to be released in July and then in August. Bell declined to speculate on what or when HHS Secretary Mike Leavitt would decide about releasing VistA-Office. In related news, Health Data Management reports that a recent web and telephone survey of more than 3,600 physician group practices found the average capital cost for implementing an EHR system was $33,000 per physician, with another $1,500 per physician per month in maintenance fees. Costs are somewhat lower for larger practices and higher for smaller ones. Read Government Health IT's article, "Free EHR Software is on Hold." Read Health Data Management's article, "Survey: $33,000 per Doc for E-Records." September 13, 2005 OCR Offers More Guidance on Compliance & Enforcement in Disaster Situations The Office for Civil Rights (OCR) has released a second bulletin addressing circumstances arising from the devastation of Hurricane Katrina. The bulletin provides additional guidance regarding how the Privacy Rule may apply to the disclosure of protected health information (PHI) to those who are treating evacuees in shelters, particularly where business associates or their agents are involved in facilitating the provision of this information. The bulletin also describes OCR's enforcement approach in light of the emergency circumstances necessitating these disclosures. Read "Hurricane Katrina Bulletin #2: Compliance Guidance and Enforcement Statement" (PDF). September 9, 2005 Leavitt: Katrina Demonstrates Need for E-Health Records Department of Health and Human Services (HHS) Secretary Mike Leavitt, speaking at the HIT & HIPAA Summits sponsored by the e-Health Initiative yesterday, said that the majority of the one million people displaced by Hurricane Katrina have no medical records, making it difficult for clinicians working in disaster medical centers to treat them, reports Government Health IT. "If there was ever a case for [electronic health records], this disaster underscores the need," Leavitt said. Medical personnel working at makeshift hospitals in the hurricane-battered Gulf Coast and at facilities in cities caring for Katrina evacuees are handicapped by the lack of medical records, including medications prescribed to former Gulf Coast residents now scattered at shelters nationwide. September 7, 2005 NY Security Breach Notification Law May Become National Standard New York's data security breach notification law, the 19th state to pass such legislation, will require all companies that do interstate business to abide by its provisions; it is stricter than the California law that has become "the de facto standard," reports SANS NewsBites. The New York law makes no exceptions for small data breaches, companies with their own disclosure policies, or breaches unlikely to result in identity theft. Data brokers have called for a national breach notification law to preempt a "patchwork" of state laws, and a data breach bill is likely to be one of the top technology-related bills in Congress during the rest of 2005. Read InfoWorld's article, "Congress Looks to Pass Data Breach Law." September 6, 2005 OCR Gives Guidance on Disclosing PHI in Disaster Situations The Office for Civil Rights (OCR) has released a Special Bulletin on disclosing protected health information (PHI) in emergency situations, in response to the devastation that Hurricane Katrina has caused to parts of the country. The bulletin emphasizes how the HIPAA Privacy Rule allows covered entities to share patient information to assist in disaster relief efforts by addressing treatment, notification, imminent danger, and facility directories. September 1, 2005 CMS Postpones Sept. 14 NPI Roundtable The September 14, 2005 HIPAA National Provider Identifier (NPI) Roundtable is postponed, and will be rescheduled for a later date. For the latest information, keep checking CMS' HIPAA web site.
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