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AHA calls for more informal enforcement procedures for TCS

HIPAA Weekly Advisor, June 20, 2003

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Enforcement procedures for HIPAA's transactions and code sets rule should be more informal and quick than those for privacy and security violations, according to the American Hospital Association's (AHA) June 16 letter to HHS.

"The processing and payment of health care claims is one of the key HIPAA transactions," read the letter. "If a hospital receives the Secretary's notice of proposed determination for a violation of the transactions rule, such notice could lead to cessation of claims submission or could result in a significant delay in the submission of claims as the hospital reverts to paper processes in order to correct or avoid an alleged violation."

Although AHA expressed overall support for the procedural requirements set forth in the first installment of the enforcement rule and HHS' continued commitment to working informally with covered entities to resolve compliance issues, the group urged HHS to track the Office of Inspector General's enforcement procedures more closely to protect covered entities' due process rights. AHA also urged the Office for Civil Rights to provide more assistance and clarification on the following issues:

• Decreasing the burden of accounting of disclosures
• Clarifying business associate relationships
• Expanding education and outreach to physicians
• Helping patients and their families understand the privacy rule requirements
• Educating the media about limitations on disclosure of patient information
• How covered entities should balance their provider and employer obligations under HIPAA

Go to http://www.aha.org and look under "What's New" to download a PDF of the comment letter.

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