Fif­teen years af­ter HIPPA pas­sage

Some pro­vi­sions still a work in progress

Modern Healthcare - - Front Page - Joseph Conn

Fif­teen years ago, the Health In­surance Porta­bil­ity and Ac­count­abil­ity Act breezed through Congress and, on Aug. 21, 1996, Pres­i­dent Bill Clin­ton signed it into law. The law re­mains vi­tal, de­spite its age, with sev­eral key HIPAA com­pli­ance dead­lines loom­ing. They in­clude Jan. 1, 2012, for use of the ASC X12 Ver­sion 5010 data trans­mis­sion stan­dards, as well as two stan­dards for re­tail phar­ma­cies and Med­i­caid phar­macy sub­ro­ga­tion, and Oct. 1, 2013, for use of ICD-10 di­ag­no­sis and pro­ce­dure codes.

The once pop­u­lar and sub­se­quently oftbe­moaned law has its share of mea­sured de­fend­ers.

“It all de­pends on your def­i­ni­tion of suc­cess,” said Robert Ten­nant, se­nior pol­icy ad­viser for the Med­i­cal Group Man­age­ment As­so­ci­a­tion.

The aim of one ma­jor sec­tion of HIPAA, “ad­min­is­tra­tive sim­pli­fi­ca­tion,” was to con­trol ris­ing health­care costs through com­put­er­i­za­tion and data stan­dard­iza­tion. “By stim­u­lat­ing the in­dus­try to move more to­ward stan­dard­iza­tion and think­ing more about stan­dard­iza­tion, it was very suc­cess­ful,” Ten­nant said, but, “Did it suc­ceed in driv­ing out costs? No.”

In­tro­duced in the Se­nate by co-spon­sors Sens. Ed­ward Kennedy (D-Mass.) and Nancy Kasse­baum (R-Kan.), the wildly pop­u­lar bill passed by votes of 98-0 in the Se­nate and 4212 in the House. It tar­geted a then-wide­spread payer prac­tice of ex­clud­ing cov­er­age to peo­ple for their pre-ex­ist­ing med­i­cal con­di­tions. Group plans of­fered to small em­ploy­ers as well as in­di­vid­ual health plans were ex­empt, how­ever. Thus, it will be left to the Pa­tient Pro­tec­tion and Af­ford­able Care Act of 2010 to elim­i­nate ex­clu­sions for pre-ex­ist­ing con­di­tions en­tirely, and not un­til 2014, 18 years af­ter HIPAA be­came law.

“From an in­surance per­spec­tive, I think it’s had a sig­nif­i­cant im­pact, be­cause it did change the way we looked at health in­surance and made it trans­fer­able,” said Dan Rode, vice pres­i­dent for advocacy and pol­icy at the Amer­i­can Health In­for­ma­tion Man­age­ment As­so­ci­a­tion. Peo­ple with med­i­cal con­di­tions were no longer locked into a job over fear of los­ing health­care cov­er­age. “I think it re­al­ized a lot of ben­e­fit from that stand­point.”

And while ad­min­is­tra­tive sim­pli­fi­ca­tion re­mains a work in progress, Rode said, “I think we’re fi­nally rec­og­niz­ing the im­por­tance of data in health­care, and that’s ex­cit­ing. And that’s cer­tainly what HIPAA was sup­posed to do. I think in an­other 15 years or so, we’ll re­ally have some­thing to pat our­selves on the back about.”

Lawrence Hughes, as­sis­tant gen­eral coun­sel for the Amer­i­can Hos­pi­tal As­so­ci­a­tion and its ex­pert on HIPAA pri­vacy and se­cu­rity, noted that the law cre­ated a first set of na­tion­wide stan­dards in that arena and that the AHA and its mem­bers “sup­port a lot of things that have oc­curred with pri­vacy and se­cu­rity with re­gards

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