Health Law

HIPAA and HIT Changes in Patient Protection and Affordable Care Act

By William Maruca

Buried in the 906 pages of the healthcare reform bill signed into law on March 22 are a number of changes that will have an impact on health information technology. Among the changes are standards which, when implemented, will reduce or eliminate the need to submit paper attachments with claims, a pet peeve of many healthcare providers. The inability of most electronic systems to accept required attachments digitally has discouraged many providers from fully implementing electronic claims submission.

Section 1104 of the Act tweaks HIPAA's administrative simplification provisions by requiring the Secretary of Health and Human services to adopt standards for health care transactions which enable point-of-care eligibility determinations; minimize the need for paper attachments to claims submissions; describe all data elements (including reason and remark codes) in unambiguous terms, require that such data elements be required or conditioned upon set values in other fields, and prohibit additional conditions (except where necessary to implement State or Federal law, or to protect against fraud and abuse). 

The Secretary is directed by Congress seek to reduce the number and complexity of forms (including paper and electronic forms) and data entry required by patients and providers.

Health plans will be also required to adopt 'unique health plan identifier' numbers by 2012.

Health plans will need to certify their compliance with the new standards by 2015. Penalties for noncompliance begin on April 1, 2014.

Full post as published by HIPAA Health Law & Technology on March 25, 2010 (boomark / email).