Mid-Atlantic Health Law TOPICS

On December 21, 2022, the Department of Health and Human Services (HHS) proposed a rule (Proposed Rule) that: would adopt new Health Insurance Portability and Account-ability Act (HIPAA) standards for health care attachment transactions and electronic signatures; and would modify referral certification and authorization transaction standards.

Under HIPAA and the Affordable Care Act, the Secretary of HHS is required to adopt standards for certain transactions to enable health information to be exchanged more efficiently and to achieve greater uniformity in the transmission of health information.

The Secretary found that transmitting health care attachments is still primarily a manual process, which costs the health care industry millions of dollars each year. Accordingly, the Proposed Rule intends to create a fully electronic system for attachments required for prior authorizations and claims.

A. New Definitions

The Proposed Rule includes definitions of two new terms, “attachment information” and “electronic signature.”

The proposed definition of “attachment in-formation” is documentation that enables the health plan to make a decision about health care that is not a health care claim, equivalent encounter information, or a referral certification or authorization transaction.

The proposed definition of “electronic signature” is “an electronic sound, symbol, or process, attached to or logically associated with attachment information and executed by a person with the intent to sign the attachment information.”

HHS is accepting comments on these pro-posed definitions, and the intent was to define these terms broadly enough that they encompass future technological changes.

B. Effective Date

All HIPAA covered entities would be impacted by this Proposed Rule. Covered entities include all health plans, health care clearing¬houses, and health care providers that transmit health information in an electronic form in connection with a transaction for which the Secretary has adopted a standard.

Likely, covered entities will incur several one-time costs to implement the new rules. The Secretary identified those costs as coming from, among other things, “analysis of business flow changes, software procurement or customized software development, integration of new software into existing provider/vendor systems, staff training, and collection of new data, testing, and transition processes.”

If adopted, all covered entities would need to comply with the new rule 24 months after the effective date of the final rule.

Darci M. Smith
410-576-4153 • dsmith@gfrlaw.com