June 27, 2002

The Honorable Tommy G. Thompson
Secretary
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Washington, DC 20201

Dear Secretary Thompson:

As part of its responsibilities under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the National Committee on Vital and Health Statistics (NCVHS) has reviewed the Notices of Proposed Rule Making (CMS-0003-P and CMS-0005-P) proposing modifications to the original HIPAA transaction and code set standards. We offer the following comments:

  1. NCVHS supports the modification to the Electronic Transactions Final Rule and the “addenda” (as identified in CMS-0005-P) as valuable and necessary changes to the standards that should mitigate identified issues and improve the HIPAA implementation.
  2. NCVHS supports the modifications to the Electronic Transactions Final Rule (as identified in CMS-0003-P) as valuable and necessary changes to the standards that should mitigate identified issues and improve the HIPAA implementation. However, we wish to raise a concern that the absence of any standard code for non-retail pharmacy claims should not lead to a proliferation of payer-developed local codes (similar to the HCPCS level III codes). Use of such codes, which might be developed as an alternative to HCPCS and NDC, should be prohibited in the standard transactions.

In addition, we would recommend that a replacement standard code set for NDC for reporting drugs and biologics in non-retail pharmacy standard transactions not be named. We believe this will give the industry time to fully evaluate its current practices and identify preferred alternatives. We are also hopeful that there will shortly be a new drug coding system available for evaluation and testing that may better meet the needs of the industry. We would recommend delaying naming a code set standard until this new drug coding system has been evaluated and tested.

We further recommend that HHS publish these modifications in final form as soon as possible so that covered entities have as much time as possible to implement the changes prior to the April 2003 date specified for testing transactions in the Administrative Simplification Compliance Act (ASCA).

NCVHS wishes to thank you for the opportunity to submit these recommendations within the framework of the Administrative Simplification provisions of HIPAA.

Sincerely,

/s/

John Lumpkin, M.D., M.P.H.
Chair, National Committee on Vital and Health Statistics

cc: HHS Data Council Co-Chairs