Ready, set, wait! HCFA delays release dates for security regs
February 1, 2000 4 minutes read
Ready, set, wait! HCFA delays release dates for security regs
Deadline for comments on privacy regulations extended
After putting the industry on notice for November and December issuance of final standards on electronic health information, the Health Care Financing Administration (HCFA) in Baltimore now says final rules will not be released until early this year. The holdups appear to be the need to coordinate privacy and security regulations and to develop standards for electronic signatures.
It is possible that HCFA will release the final standards to coincide with Department of Health and Human Services’ (HHS) issuance of final privacy standards, originally set for release on the 21st of this month. However, HHS was expected to push that release date back to accommodate a new comment period that has been extended through Feb. 17. (See Hospital Payment & Information Management, January 2000, p. 1.)
"It is my belief this was due to the industry’s focused attention on Y2K planning," says Christopher Assif, president and CEO of Health Ventures Network in Downers Grove, IL. "As everyone knows, health care is lagging behind many industries as it relates to testing and preparedness. HHS realized a three-month extension would be the benefit of everyone involved."
"I’m not surprised that HCFA is delaying final rules for a few months," says Mary Brandt, MBA, RRA, CHE, vice president for professional services in Quadramed’s health information solutions division in Houston. "I suspect that HCFA needs more time to get everything finalized. They may have received a large number of comments, and they may want additional time to evaluate those comments before implementing final rules."
At a December conference, a HCFA official revised the release schedule for the remaining Health Insurance Portability and Accountability Act of 1996 (HIPAA) administrative simplification notices of proposed rulemaking (NPRMs) and the HIPAA final rules.
Initially, the final rule for Transactions and Coding was going to be released last November. The final rules for the national provider identifier (NPI), national employer identifier, and security were expected to follow in December. In an announcement to attendees of the 1999 Washing-ton Policy Forum of the Phoenix-based Associ-ation for Electronic Healthcare Transactions, HCFA official Stanley Nachimson said the final rule for transactions and coding would be published at the beginning of this year. Final rules for security and the NPI would most likely be published around March 2000, Nachimson told the group.
The final rule for security standards would be delayed because of the "need to harmonize the privacy and security regulations as well as the lack of an industry standard for electronic signatures," William R. Braithwaite, MD, PhD, FACMI , senior advisor on health information policy for HCFA told a HIPAA conference in November co-hosted by the Data Interchange Standards Association in Alexandria, VA, and the Workgroup for Electronic Data Interchange in Reston, VA.
HCFA officials say that many of the HIPAA rules are in the final stages of HHS’ clearance process and must still go to the Office of Management and Budget prior to publication in the Federal Register, reports the Medical Management Group Association (MGMA) in Englewood, CO.
The NPI rule has hit a snag, HCFA officials said. The NPI will be delayed because Congress failed to appropriate money to fund the provider payment process, and HCFA lawyers have indicated that Medicare funds cannot be used to pay non-Medicare providers.
HCFA does not want to move forward with the NPI unless a mechanism is found to allow all providers to be paid, MGMA says. Braithwaite told the conference that the provider identifier is likely to change from the proposed eight- position alphanumeric number to a 10-digit numeric number.
In addition, Nachimson said that the proposed rules for health plan identifier and claims attachments should be published in the first quarter of 2000. The rule for the health plan identifier has been slowed by the difficulty in defining exactly what a "health plan" is. However, HCFA officials told MGMA that this issue has been resolved and the clearance process is moving forward.
Next year, HHS will begin work on a proposed rule for an individual identifier and may release an additional proposed rule governing the protection of paper records printed out from electronic records, Braithwaite said. The NPRM for medical records standards is not expected until the summer of 2000 or later, HCFA officials told the MGMA. Currently, the National Committee on Vital and Health Statistics (NCVHS) is holding hearings prior to the forwarding of its recommendations to the HHS Secretary. The NCVHS recommendations on standardized medical records will provide the foundation for the NPRM.
Finally, the Clinton administration announced in December that it would extend the deadline for public submission of comments on its proposed health privacy regulations.
The announcement was made in response to requests from the Health Privacy Project and the Consortium for Citizens with Disabilities, both in Washington, DC, as well as provider groups, payer groups, and other organizations.
"Giving the health care industry more time for comments may well mean the final rules are more reasonable, if those comments have been incorporated," Brandt said.
The proposed rule on privacy and confidentiality was issued by President Clinton on Oct. 29. No change has been made on the deadline for issuance of the final rule, but it is expected to be adjusted to reflect the comment period extension. Nachimson said the final rule should be released as early as possible in 2000. He also expects that the effective date of the final rules should stay at 60 days.
(Editor’s note: For more information on HIPAA rulemaking, visit the Administrative Simplification Web site at http://aspe.os.dhhs.gov/admnsimp/.)
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