HHS Extends Comment Period for Proposed Rule on Health Care Attachments Standards for HIPAA Covered Entities; Comments Due April 21
Published March 24, 2023
The Department of Health and Human Services (HHS) released an extension to the comment period for the 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 comment
period for the proposed rule initially ended on March 21, 2023, but has
been extended to April 21, 2023 by 5 p.m. ET.
(updated March 24, 2023)
The Department of Health and Human Services (HHS) has released a proposed rule
that would implement standards for “health care attachments”
transactions, such as medical charts, x-rays, and provider notes that
document physician referrals, and office or telemedicine visits. The
modifications to the adopted Health Insurance Portability and
Accountability Act of 1996 (HIPAA) transactions would support both
health care claims and prior authorization transactions, standards for
electronic signatures to be used in conjunction with health care
attachments transactions, and a modification to the standard for the
referral certification and authorization transaction. The proposal is
intended to make the process of submitting and adjudicating health care
claims more efficient by providing structured, standardized electronic
data to payers. The proposed rule would define the term “electronic
signature” as broadly as possible.
HIPAA and the Affordable
Care Act require the HHS Secretary to adopt a health care claim
attachment standard. HHS is proposing these new requirements on
HIPAA-covered entities, which include health plans, health care
clearinghouses, and health care providers who electronically transmit
any health information in connection with transactions for which HHS has
adopted standards.
Health Care Attachments
- Prior Authorization: A provider must obtain a health plan’s approval for a service before it is rendered to the patient.
- Solicited Documents: A provider has submitted a claim for a rendered service and the health plan decides that more information is required to make a payment determination. The health plan requests more information from the provider and the provider responds.
- Unsolicited Documents: A provider submits a claims attachment along with their initial submission of a health care claim transaction for a service they have rendered. This usually occurs when a provider is in a full claims review program with the health plan or the health plan’s payment policies require documents with each claim submission for service.