How does HIPAA impact the MDS?
HIPAA Weekly Advisor, December 28, 2001
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Q: Our long-term care facility submits minimum data set (MDS) information for resident assessment and for reimbursement. Are we required to comply with the HIPAA privacy and transaction standards?
A: Nursing homes are required to collect and submit patient assessments as a condition of participation in Medicare and Medicaid programs. The MDS resident assessment data collected could also be used to complete the 837 claim form. In fact, many states use this data to set prospective payment rates for long-term care residents.
HIPAA transaction rules do not cover the MDS data submission, but the data are covered by privacy rules. If you plan to use the MDS data set for claims payment, you must use the 837 transaction format (ANSI X12N837 4010 Institutional Claim).
Go to http://www.afehct.org or http://snip.wedi.org for more details on the 837 format.
Answered by Jon Bogen, president of HealthCIO Inc. in Duxbury, MA. If you have a question for him, write to BOH, P.O. Box 1168, Marblehead, MA 01945, or send an e-mail to HIPAA Weekly Advisor editor Brian Driscoll at bdriscoll@hcpro.com.
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