September 27, 2001
John Lumpkin, M.D., M.P.H.
Chair, National Committee on Vital and Health Statistics
6525 Belcrest Road
Room 1100
Hyattsville, MD 20782-2003
Dear Dr. Lumpkin:
Thank you for your letters regarding the implementation of the administrative simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). You raise many important issues, several of which are under active discussion at the Department of Health and Human Services (the Department).
We would like to respond to the specific recommendations in your letters. Because of the number of recommendations and our wish to be responsive to you in terms of current efforts at the Centers for Medicare & Medicaid Services and the Department, we have prepared an enclosure.
As always, we welcome your recommendations regarding implementation on HIPAA’s administrative simplification provisions. The National Provider Identifier final rule cannot be published until budget commitments for the costs of enumeration have been made, which we do not expect before FY 2003. As we continue implementation efforts, we look forward to working with the National Committee on Vital and Health Statistics.
Sincerely,
/ s /
Claude A. Allen
Deputy Secretary
Enclosure
RECOMMENDATIONS AND RESPONSES ON HIPPA IMPLEMENTATION
Recommendation:
Provide early guidance on new policies.
Response:
We have provided guidance on several occasions (including providing guidance on the privacy regulation and sending you a letter regarding our intention to publish a proposed rule revising the drug coding standard) and will continue to do so whenever feasible. However, we are not able to provide information on final rules which are in the formal clearance process.
Recommendation:
Allow flexibility in the enforcement of the new standards.
Response:
The Department is planning to develop a regulation on enforcement of the HIPAA standards and will take your advice into consideration when we begin.
Recommendation:
Oppose delays in the compliance dates for the HIPAA standards such as those found in section 836.
Response:
We share your concern regarding the potential effects of delays. However, the Administration has taken no position on the pending legislation. We are proceeding with the compliance dates as stated in final regulations.
Recommendation:
Publish and implement HIPAA regulations quickly.
Response:
We recognize the need to issue these regulations as soon as possible. The Department is working toward publishing the final rule on security, and a proposed rule on a claims attachment standard, by the end of the year. The National Provider Identifier rule is currently under development.
Recommendation:
Expedite the HIPAA change process.
Response:
We are committed to working with designated standards maintenance organizations (DSMOs) in order to streamline the process and will work to publish the recommended changes in regulations as soon as possible.
Recommendation:
Explore consistent standards for paper transactions.
Response:
We will work through our Department representatives to the National Uniform Claim Committee and to the National Uniform Billing Committee to bring this issue to the attention of the Committee.
Recommendation:
Accept DMSO recommendations for changes to the standard electronic transactions and code sets.
Response:
The Department has already begun the development of the regulations necessary to adopt these changes and intends to publish them as quickly as possible. We are working toward publication of a final rule early in Calendar year 2002. In addition, in order to ease your concerns regarding the coverage of the standard code sets, we will monitor the efforts of code set maintainers to ensure they are meeting the needs of the health care industry.