Two HIPAA final regulations, those for Security Standards, and for
Modifications to the Transactions Standards, went on display today at
the Office of The Federal Register . They will be published
in the February 20, 2003 edition of the Federal Register.
Copies of the rules can be viewed at Centers
for Medicare & Medicaid Services Website
These are the versions that were sent to the Office of the Federal
Register. The Federal Register versions will be made available, via
links, from this website.
Under the security standards announced today, health insurers,
certain health care providers and health care clearinghouses must
establish procedures and mechanisms to protect the confidentiality,
integrity and availability of electronic protected health information.
The rule requires covered entities to implement administrative, physical
and technical safeguards to protect electronic protected health
information in their care.
The security standards work in concert with the final privacy
standards adopted by HHS last year and scheduled to take effect for most
covered entities on April 14, 2003. The two sets of standards use many of the
same terms and definitions in order to make it easier for covered
entities to comply.
Covered entities (except small health plans) must comply with the
security standards by April 21, 2005. Small heath plans will have an
additional year to comply.
The final transaction modifications rule, which will also be
published in the Federal Register on Feb. 20, 2003 combines two proposed
rules published May 31, 2002. HHS worked extensively with the Designated
Standards Maintenance Organizations (DSMOs) to revise the proposed
changes to the standards, as required by Congress as part of HIPAA.
Major provisions of the final rule include:
- Repealing the National Drug Code (NDC) as the standard medical
data code set for reporting drugs and biologics in all non-retail
pharmacy transactions.
- Adopting a proposed Addenda to the implementation guides with some
technical revisions based upon comments received and consultation
with the DSMOs.
For retail pharmacy transactions:
- Adopting the National Council for Prescription Drug Programs (NCPDP)
Batch Version 1.1 to support the Telecommunications Version 5.1
- Adopting the Accredited Standards Committee (ACS) X12N 835
as the standard for payment and remittance advise and the NCPDP
Telecommunications Version 5.1 and NCPDP Batch Version 1.1.
Implementation Guides as the standard for the referral certification
and authorization transaction.
- Continuing the use of NDC code set for the reporting of drugs and
biologics.
The rule also adopts modified standards for two transactions that
were not included in the proposed rules -- premium payments, and
coordination of benefits. The modifications were approved by the DMSOs
and merely provide explanatory guidance.