HIPAA Regulatory Alert

Vendors agree on HIPAA interpretation 43% of time

The HIPAA Conformance Certification Organization (HCCO) says its Common Compliance Assessment Process determined that, on average, the nation’s leading HIPAA translation and validation vendors agree in their interpretation of compliance 43% of the time, up from an average of 35% on all transactions in 2003.

The assessment is an advanced testing process that performs detailed analysis of HIPAA compliance edits across all vendors simultaneously. Testing takes place in a neutral environment to uncover compliance differences among participants and work to align edits. Participants in the 2003 and first quarter 2004 testing represent some 80% of the translators and validators installed in U.S. health plans, HCCO says.

"We have come a very long way, but there is still much work to be done in the process of aligning compliance edits in HIPAA translation and validation software," says HCCO chairman Mark Lott. "Many of the differences can be traced to differences of opinion within the language of the implementation guides, but with the help of X12, the authority for interpretation, we have made great strides in moving this key initiative forward. A very important result of the CCAP testing effort is that while differences of interpretation are present in the beginning of the testing process, all vendors have the same interpretation upon completion of the program. To date, CCAP has tested more than 1,100 transactions representing close to 100,000 various compliance edits, and through this effort the majority of the industry has the same understanding of compliance."