The devil’s in the details

On Oct. 21, 1998, President Clinton signed the Omnibus Spending Bill into law. The measure included spending bills for the following: Labor, Health and Human Services (HHS), and Education; Agriculture; Commerce, Justice, State; District of Columbia; Foreign Operations; Interior; Treasury and Postal Service; and Transportation.

Here are details of the bill, as analyzed by the Joint Healthcare Information Technology Alliance:

• Includes a measure that prohibits the secretary of HHS from promulgating or adopting standards providing for a unique health identifier (UHI) without first obtaining explicit congressional approval. Thus, two years after directing the secretary to create such a unique identifier, Congress has indicated that it intends to review the issue again, and many observers anticipate the introduction of legislation next year that would repeal this provision of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Earlier, the Clinton administration announced that no UHI would be implemented until comprehensive privacy legislation is passed by Congress.

• Includes substantial across-the-board funding for HHS (substantial increases for AIDS treatment, disease prevention, and biomedical research); hastens phase-in of full tax deductibility of health insurance for the self-employed; and provides a fix for Medicare’s home health interim payment system.

• Includes the Internet Tax Freedom Act that establishes a moratorium that no state or political subdivision may impose any of the following taxes from Oct. 1, 1998, and extending for three years from the date of enactment on Oct. 21: taxes on Internet access, unless such tax was generally imposed and actually enforced prior to Oct. 1, 1998; and multiple or discriminatory taxes on electronic commerce.

• Establishes an Advisory Commission on Electronic Commerce that shall conduct a thorough study of federal, state, and local, and international taxation and tariff treatment of transactions using the Internet and Internet access and other comparable intrastate, interstate, or international sales activities. The Commission shall provide a report to Congress within 18 months reflecting the results of the study, including any recommendations for legislation.

• Provides $45 million for the Health Care Financing Administration transition to a single Part A and Part B processing system and year 2000 conversion requirements of external contractor systems.

• Provides $1 million for the National Bipartisan Commission on the Future of Medicare for fiscal year 1999.

AHA CD for easier access to clinical coding info

The Chicago-based American Hospital Association (AHA), in partnership with 3M Health Information Systems, announced a new product that will provide health care billing and medical records personnel easier access to clinical code information.

The new product is a CD-ROM version of the quarterly publication Coding Clinic on ICD-9-CM. Widely used for research and insurance purposes, ICD-9-CM is a classification system for coding patient medical information and grouping patient diagnoses and procedures. The CD improves coding productivity by allowing users to quickly and easily access and search 14 years of coding advice.

The Coding Clinic CD-ROM provides users with electronic linkages to relevant coding-related issues, quarterly updates, and 3M Health Information Systems’ notes and correction notices about the system. In addition, users can print hard copies of the information that they need.

The CD-ROM is available in stand-alone and a multi-user/network versions. The annual subscription includes quarterly updates and a hard copy version. To order or request additional information, call (800) 242-2626 or visit the AHA’s on-line catalog at

Partnership expands year 2000 resources

A partnership between Rx2000 Solutions Institute, a member-supported organization helping the U.S. health care system prepare for year 2000 (Y2K), and MedSeek, Internet and intranet specialists, will provide institute members free use of database tools and inventory compliance testing results through a custom on-line system.

The Rx2000 Solutions Institute’s Rx2000 Healthcare Products Database, available to members since July, reviews compliance data from a variety of sources, including on-site hospital test results, for thousands of biomedical devices. Using remote communication and data management provided by modern Web technology, the MedSeek product will offer members their own custom database tracking tool for management of Y2K product assessment.

Institute members receive password-protected access to a private Y2K site where on-line administration allows the members to post unlimited inventory records and maintain testing results for their own use.

Simultaneously, each member anonymously contributes that data to a common data pool for comparison. For example, before testing a specific piece of biomedical equipment, an Institute member could immediately search the database and know in advance if other hospitals found the equipment failed Y2K testing.

The Rx2000 database is Web-based and accessible free of charge to members of the Rx2000 Solutions Institute at


The American Hospital Association’s 1999 annual meeting, "Coverage, Quality, Trust: Cornerstones for a New Century of Community Care," will be held Jan. 30-Feb. 2, 1999, Washington, DC.

For registration information, call (888) 447-2343 or visit the Web site: annualmeeting.