Posted January 18, 2023
The Department of Health and Human Services (HHS) has issued a proposed rule titled Administrative Simplification: Adoption of Standards for Health Care Attachments Transactions and Electronic Signatures, and Modification to Referral Certification and Authorization Transaction Standard
The rule would adopt a set of standards for the electronic exchange of clinical and administrative data to support prior authorizations and claims adjudication. According to HHS, despite widespread deployment of electronic health records (EHRs), and industry experience with Health Insurance Portability and Accountability Act of 1996 (HIPAA) standards that continues to advance since HIPAA’s advent, transmitting health care attachments is still primarily a manual process and, at this time, there are no adopted HIPAA standards, implementation guides, or operating rules for health care attachments or electronic signatures. If adopted, this proposed rule would support electronic transmissions of this type of information rather than the use of manual processes such as mail and fax that still predominate in the health care industry.
Specifically, this proposed rule would adopt standards for “health care attachments” transactions, which would support both health care claims and prior authorization transactions, and a standard for electronic signatures to be used in conjunction with health care attachments transactions. To better support the use of the proposed standards for attachments transactions with prior authorization transactions, this rule also proposes to adopt a modification to the standard for the referral certification and authorization transaction (X12 278) to move from Version 5010 to Version 6020.
CMS is hosting a free webinar that will provide a public forum for CMS to provide an overview of the proposed rule. The call will cover the following topics:
• Background on the current standards
• What the proposed rule would do
• How to submit comments on the proposed rule
Click here to register.
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