HIPAA Regulatory Alert

Survey shines light on HIPAA compliance efforts

Nonprovider compliance improves

The summer 2003 Industry HIPAA survey conducted by HIMSS (Healthcare Information and Management Systems Society) and Phoenix Health Systems found that "not enough time" was seen as the major roadblock to meeting the Oct. 16 implementation deadline for transactions and code sets (T&CS). And that report helped set the stage for CMS and others to apply their contingency plans and continue to accept noncompliant claims.

In online surveys completed in early July, 81% of providers said they had either completed or expected to have completed their T&CS gap analysis before October. But only 74% said they would have implemented all T&CS changes by October. The researchers said, "lack of cooperation/communication among industry segments remains an ongoing impediment."

Provider readiness for October for various types of transactions ranged from 1% for "None" and 6% for the 820 transaction form to 76% for the 837. For payers, readiness ranged from 3% "None" and 45% for the 820 to 84% for the 837. Obstacles cited by providers included payer not ready to test (48%), payer not ready for the transaction type (37%), noncompliant software (29%), and internal data collection (27%).

In another aspect of HIPAA, the surveyors said that nonprovider privacy compliance had improved dramatically since the group’s spring report. Reporting compliance were 88% of clearinghouses (up from 47%), 81% of vendors (up from 39%), and 85% of payers (up from 68%). At 77% (down from 78% in April), providers were the least privacy-compliant segment of the health care community. HIMSS and Phoenix said that hospital budgets for HIPAA compliance in 2003 generally are higher than they were in 2002, but spending seems to be leveling off.

For survey information, contact Phoenix Health Systems at (301) 869-7300 or e-mail info@phoenixhealth.com.