AHA urges CMS: More transactions guidance

Recent guidance by the Centers for Medicare & Medicaid Services (CMS) on Health Insurance Portability and Accountability Act (HIPAA) transactions standards did not go far enough, says the American Hospital Association (AHA), which has urged CMS to respond to what the AHA calls critical issues that have not been addressed. The Health Insurance Portability and Accountability Act’s transactions standards take effect Oct. 16.

While the CMS guidance recognized the importance of maintaining uninterrupted payment for hospitals and other caregivers, it failed to outline a contingency plan with specific actions to prevent disruptions to the payment cycle, said George Arges, senior director of AHA’s Health Data Management Group.

Arges, speaking to a subcommittee of the Department of Health and Human Services National Committee on Vital and Health Statistics, also said that CMS should make clear that health plans can process a claim if it has non-material errors and should not reject an entire batch of claims because one or a few contain errors, as well as what specific actions demonstrate good-faith efforts to implement the standards.

HIPAA security rule

In another HIPAA matter, AHA has issued a regulatory advisory to its members on the final security rule, which was published Feb.20. Hospitals must be compliant with that rule by April 21, 2005. The regulatory advisory, developed with the consulting firm of Ernst & Young, describes the rule’s core requirements for hospitals, highlights significant differences between the final and proposed rules, and suggests how hospitals can jumpstart their security efforts by leveraging medical privacy rule compliance information and resources.

The advisory also identifies the key challenges that hospitals face in implementing the rule, and recommends how they can avoid these potential pitfalls. AHA members can read the advisory on-line at www.aha.org.