WebMD Corp., Elmwood Park, N.J., has released a white paper on the implementation of the Health Insurance Portability and Accountability Act (HIPAA) that concludes the law's administrative simplification provisions are increasing in complexity and costs for healthcare providers and payers across the country.The White Paper, which is the result of WebMD's analysis of HIPAA implementation nationwide, identifies concrete steps that the U.S. Department of Health & Human Services can take to steer the implementation back on course, through what the company calls a "rational roll- out plan."

The paper, entitled "HIPAA Implementation: The Case for a Rational Roll- Out Plan," explores how the law--as implemented--has not advanced HIPAA's promise of simplification, standardization and reduced cost, but rather has had the reverse effect.

It states that administrative simplification is at risk for three reasons:

  • A lack of uniformity in implementing the standards.
  • A failure by the healthcare industry to implement all of the standard transactions to enable a "two-way street" for information exchange between payers and physicians.
  • Confusing and unnecessary data content requirements.

The paper also explores how the lack of acknowledgement of receipt of information provided from a healthcare provider to a payer has emerged as an ongoing provider issue. To the extent that payers acknowledge receipt of a claim at all, the format is not uniform, and as a result, providers are not able to efficiently accept, process and respond to the information included in the acknowledgment.
WebMD urges the HHS and the agency's Centers for Medicaid and Medicare Services to take action through a series of course corrections, including:

  • Continuing the contingency period under which trading partners are operating under contingency plans.
  • Defining a HIPAA standard claims transaction to include only that content necessary for the adjudication of the claim and enforcing the content requirements only as a cap on what may be contained in a covered transaction.
  • Coordinating a rational, industry-wide roll-out that promotes the exchange of all HIPAA standard transactions, not just claims.

For a copy of the complete white paper, visit www.webmd.com/corporate/index.html

Source: WebMD Corp.

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