Standards for Electronic Healthcare
Claims Attachments

(as published in Federal Register, September 23, 2005)

HHS SUMMARY: This rule proposes standards for electronically requesting and supplying particular types of additional health care information in the form of an electronic attachment to support submitted health care claims data. It would implement some of the requirements of the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996.

On November 22, 2005, the Department of Health and Human Services (HHS) published notice (PDF) of a 60-day extension to the comment period for the proposed rule entitled, “HIPAA Administrative Simplification: Electronic Health Care Claims Attachments.” 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).

Search by keyword

PDF [631 K]

Adobe Acrobat Reader
(required to read PDF version)

Supplementary Information

1. Background
   1. Summary
   2. Legislation
   3. Standards Setting Organizations
   1. Accredited Standards Committee X12 (ASC X12)
   2. Health Level Seven (HL7)
   4. Industry Standards, Implementation Guides and Additional Information Specifications
      1. ASC X12N and the HL7 Implementation Guides and HL7 Additional Information Specifications
      2. Implementation Guides in HIPAA Regulation
2. Provisions of the Proposed Regulations
1. Definitions
2. Effective Dates
3. Overview of Key Information for Electronic Health Care Claims Attachments
4. Electronic Health Care Claims Attachment Business Use
5. Electronic Health Care Claims Attachment Content and Structure
6. Alternatives Considered: Candidate Standards for Transaction Types and Code Sets
7. Proposed Standards
8. Requirements (Health Plans, Covered Health Care Providers and Health Care Clearinghouses)
9. Specific Documents and Sources


3. Modifications to Standards and New Electronic Attachments
1. Modifications to Standards
2. Additional Information Specifications for New Electronic Attachments
3. Use of Proposed and New Electronic Attachment Types Before Formal Approval and Adoption
   
4. Collection of Information Requirements
   
5. Response to Comments
   
6. Regulatory Impact Analysis
1. Overall Impact
2. Cost and Benefit Analysis
3. Guiding Principles for Standard Selection

Regulation Text