The Secretary of the Department of Health and Human Services (HHS) has proposed a new rule outlining standards for healthcare attachments transactions and electronic signatures. This measure is in line with the Administrative Simplification Requirements of HIPAA and the Affordable Care Act, and is intended to provide health plans, healthcare clearinghouses, and healthcare providers with a uniform method of sending attachments. The new rule, if implemented, would apply to all entities that currently lack an efficient system for doing so.
The absence of HIPAA-adopted standards for healthcare attachments and electronic signatures has resulted in health plans relying on manual processes to make coverage decisions about healthcare services that require additional information that cannot be included in the specified fields or data elements of the adopted prior authorization request or healthcare claims transaction. This results in lengthy and resource-intensive processes, such as sending the information through the mail or by fax. The proposed rule looks to resolve this issue by providing support for electronic transmissions of this type of information.
In response to the Administrative Simplification Rules of HIPAA, standard-setting organizations (SSOs) were called upon to produce standard code sets for electronic healthcare transactions, some of which were integrated into the Transactions and Code Sets final rule. In 2005, the HIPAA Administrative Simplification: Standards for Electronic Health Care Claims Attachments; Proposed Rule was put introduced, requiring the adoption of standards for health care claims attachments in areas such as ambulance services, clinical reports, emergency department, laboratory results, medications, and rehabilitation services. Nonetheless, after considering the comments it had received, the HHS decided not to finalize the rule.
The American Hospital Association (AHA) has expressed its support for the proposed rule that would adopt a new HIPAA standard for attachments and electronic signatures. Terrence Cunningham, AHA director of administrative simplification policy, believes that this standard would help to reduce the administrative burden for clinicians, reduce delays in payments and patient care, and lessen the risk of provider burnout. Cunningham said, “We look forward to providing robust commentary after analyzing the rule’s specifics.” Comments on the proposed rule must be submitted by March 21, 2022, as the rule is scheduled to be published in the Federal Register on December 21, 2022.