On June 25, 2012, William Maruca, Esq., the Editor of this blog and my health law partner at Fox Rothschild LLP, published an article entitled "What small business owners should know about each possible Supreme Court health-care ruling" on washingtonpost.com. In the article Bill highlights the likely impact on small business owners of the numerous possible Supreme Court rulings in the pending Accountable Care Act case. While the subject matter goes beyond the usual focus of this blog, I thought that the comments would be of significant assistance to many of those who are following this continuously unfolding drama.
Buried in the 906 pages of the healthcare reform bill signed into law on March 22 are a number of changes that will have an impact on health information technology. Among the changes are standards which, when implemented, will reduce or eliminate the need to submit paper attachments with claims, a pet peeve of many healthcare providers. The inability of most electronic systems to accept required attachments digitally has discouraged many providers from fully implementing electronic claims submission.
Section 1104 of the Act tweaks HIPAA’s administrative simplification provisions by requiring the Secretary of Health and Human services to adopt standards for health care transactions which enable point-of-care eligibility determinations; minimize the need for paper attachments to claims submissions; describe all data elements (including reason and remark codes) in unambiguous terms, require that such data elements be required or conditioned upon set values in other fields, and prohibit additional conditions (except where necessary to implement State or Federal law, or to protect against fraud and abuse).
The Secretary is directed by Congress seek to reduce the number and complexity of forms (including paper and electronic forms) and data entry required by patients and providers.
Health plans will be also required to adopt “unique health plan identifier” numbers by 2012.
Health plans will need to certify their compliance with the new standards by 2015. Penalties for noncompliance begin on April 1, 2014.