NDCHealth's Participation In The Standards Process

We feel that participation in the regulatory process is necessary in order to simplify health care business processes and models, in achieving standardization, and in protecting the confidentiality of information as it is exchanged and stored. NDCHealth has had a long-standing history of participation and support of standards programs. We have been applying these principles in our systems design and implementations for more than 20 years. We participate in and have had representation in organizations such as NCPDP, DISA, ASC X12, WEDI, AFEHCT, and UN/EDIFACT/CEFACT.

Administrative simplification cannot be achieved through technology and standards alone, but is a combination of business processes, technology, and experience in applying practices and tools that will culminate in administrative simplification.

How Does HIPAA Fit?

HIPAA is the acronym for the Health Insurance Portability and Accountability Act that was signed into law on August 21, 1996, Public Law 104-191. This law impacts all areas of the health care industry and was designed to provide insurance portability, to improve the efficiency of health care by standardizing the exchange of administrative and financial data, and to protect the privacy, confidentiality and security of health care information.

Health Insurance Portability and Accountability Act of 1996 (P.L. 104-191

The law is designed to improve portability and continuity of health insurance coverage, to combat waste, fraud and abuse in health insurance and health care delivery, to promote the use of medical savings accounts, to improve access to long-term care services and coverage, to simplify administration of health insurance, and for other purposes. [H.R. 3103]

NDCHealth supports the HIPAA objectives and is proactively enhancing our existing HIPAA compliance initiatives on behalf of our customers.

Administrative Simplification

The intent is to simplify administrative and financial data transactions by defining new codes and unique identifiers and by standardizing transactions and EDI formats. Hospitals, physician offices, home health agencies, nursing homes, affiliated providers, payers, employers, data services, and regulatory agencies are impacted by HIPAA.

The complete text of the proposed and finalized rules, along with comments, is available at: http://aspe.hhs.gov/admnsimp.

Transaction Sets impacted:

Health Care claim or encounter information
Enrollment and disenrollment in a health plan
Eligibility for a health plan
Claim payment and remittance advice
Premium payments
Health Care claim status
Referral certification and authorization
Health Care claim attachment
First report of injury

Security

Reasonable and appropriate administrative, technical and physical safeguards are to guard the integrity and confidentiality of information, protect against reasonably anticipated threats or hazards to security and integrity of the information and unauthorized uses or disclosures of the information, and to maintain standards of compliance by officers and employees of applicable entities. For more information on security, please reference: http://aspe.hhs.gov/admnsimp

NDCHealth, in coordination and cooperation with its trading partners, works to provide as secure an environment as is reasonably and technically possible.

NDCHealth's HIPAA Initiative:

"Track and provide coordination, encouragement, education, communication, and legal interface for all HIPAA activities throughout NDCHealth. Monitor and verify that HIPAA efforts for readiness and compliance are proceeding accordingly within NDCHealth responsible organizations."

For additional information, see http://www.hipaacomply.com or contact: