David - I fully agree.  The direction I was taking was Section 160.102 and
the definition of a covered entity.  If you are a "health care provider who
transmits any health information in electronic form in connection with a
transaction covered by this subchapter."

If you are doing everything on paper and not transmitting info in connection
with a transaction you listed below, then you do not meet the definition of
a covered entity and HIPAA does not apply.

However, in this scenario, if you are not a covered entity, then does that
make you a Business Associate?  If this is so, then a physician office doing
everything on paper would not be able to exchanged information for PHI
without an authorization or BAC, etc...........

Thoughts??

Dan Kelsey
Data Projects Coordinator
Indiana State Medical Association
(317) 261-2060
(317) 261-2222 fax


-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]]
Sent: Friday, May 10, 2002 9:14 AM
To: Dan Kelsey
Subject: RE: minimal compliance?


I think it is important for us, as professionals,
to distinguish our terminology with regards to
HIPAA.

For the record, the following are HIPAA Transactions.

Electronic Transactions 1173(a)(1)


�    Health claims

�    Encounter information

�    Enrollment or disenrollment in a health care plan

�    Eligibility for a health care plan

�    Health care payment remittance

�    Premiums

�    Report of injury

�    Claim status

�    Referral information


A provider would invoke HIPAA if a provider is
sending/receiving protected health information
(PHI) to satisfy a HIPAA Transaction, as outlined
above.

Also, if a provider contracts a third party to
conduct such operations, the provider is still
covered by HIPAA.

David Sweigert, CISSP


David Sweigert, M.S., CISSP
State IT Security Policy Officer
Office of Statewide IT Policy
Computer Services Division
http://www.ohio.gov/itp
----- Forwarded by David Sweigert/CSD/DAS/OHIO on 05/10/2002 10:08 AM -----
 

                    "Isbitts, Mark"

                    <Mark.Isbitts@tri        To:     Dan Kelsey
<[EMAIL PROTECTED]>, "'Casteel, Rebekah K.'" 
                    zetto.com>               <[EMAIL PROTECTED]>, [EMAIL PROTECTED]

                                             cc:

                    05/10/2002 08:02         Subject:     RE: minimal
compliance?                              
                    AM

 

 







In addition to Dan's points, you must first define what you are (covered
entity vs. business associate).  Assuming your organization has determined
that you are a covered entity, there is really no way to avoid HIPAA
altogether.  However, by de-identifying information that is disclosed, you
can reduce the exposure since this is not considered IIHI. (Section 164.514
(a) of the Privacy Rule) Another area to consider is the use of
clearinghouse or ASP to handle some of the technical issues such as EDI
translation and code sets.  You will probably still have Privacy and
Security issues, but it certainly minimizes your HIPAA effort. Your point
about dropping Medicare and/or Medicaid may hold true but any organization
(whether CE or BA) must always considered the business implications and
issues when developing their HIPAA compliance plan.  This will certainly be
the case, as Dan points out, with providers deciding to revert back to
paper which could be a costly business decision moving forward.  Just some
thoughts.



Mark Isbitts
Mark Isbitts
Manager - Consulting
The TriZetto Group
10 Glenlake Parkway
Suite 400
Atlanta, GA  30328
770-225-3054 - office
404-395-2497 - mobile


     -----Original Message-----
     From: Dan Kelsey [mailto:[EMAIL PROTECTED]]
     Sent: Wednesday, May 08, 2002 10:38 AM
     To: 'Casteel, Rebekah K.'; [EMAIL PROTECTED]
     Subject: RE: minimal compliance?



     Rebekah,

     The only way I am aware of to minimize compliance is to submit all
     claims via paper and not conduct any electronic transactions.
     However, when I talk to physician offices that are 100% paper, I
     encourage them to not ignore HIPAA because everyone else will be doing
     things they are not, and patients will begin to wonder why.  Another
     point I mention is when the physician is negotiating a new contractor
     with a health care payer, the payer might require the electronic
     submission claims as a condition of participation.  If the physician
     signs the contract, then he/she will need to become HIPAA compliant in
     a VERY short period of time.  So, why not go ahead and do the work
     now.

     Hope this helps,

     Dan Kelsey
     Data Projects Coordinator
     Indiana State Medical Association
     (317) 261-2060
     (317) 261-2222 fax
          -----Original Message-----
          From: Casteel, Rebekah K. [mailto:[EMAIL PROTECTED]]
          Sent: Wednesday, May 08, 2002 9:23 AM
          To: [EMAIL PROTECTED]
          Subject: minimal compliance?



          I apologize if this question has been asked and answered before.
          Has anyone found a way to minimize compliance with HIPAA? For
          example, by not participating in Medicare (the ASCA requires
          electronic submission of Medicare claims by 2003), Medicaid or
          submitting claims information to any other third party payor? I
          know it seems extreme ... any help is appreciated. Thanks.


          Rebekah Casteel
          Greenebaum Doll & McDonald, PLLC
          3300 National City Tower
          101 S.5th St
          Louisville, KY 40202
          (502) 587-3670
          (502) 588-1310 (fax)
          [EMAIL PROTECTED]


               -----Original Message-----
               From: Nita Sutton [mailto:[EMAIL PROTECTED]]
               Sent: Tuesday, May 07, 2002 3:59 PM
               To: Jan Root; [EMAIL PROTECTED]
               Subject: RE: Transmitting Patient Information via Internet
               (Email)



               That's hard to say, considering the escalating dependence on
               electronic data and the impending need to secure it.
               Individual owners of digital information, whether under
               federal regulation or otherwise, will have to detemine the
               balance between security and convenience. I suspect that
               only the solutions that prove the most secure, with the
               highest usability and broad compatibility will become the
               standard, be adopted by the masses and consequently occupy
               the highly sought space on the typical hard drive.


               Nita A. Sutton  /  Marketing Manager  /  Infraworks
               Corporation  /  www.infraworks.com
               6207 Bee Cave Road  /  Austin  /  Texas  /  78746
               512-744-4215  /  800-308-5825  /  Fax 801-991-9394

                    -----Original Message-----
                    From: Jan Root [mailto:[EMAIL PROTECTED]]
                    Sent: Tuesday, May 07, 2002 2:00 PM
                    To: Nita Sutton
                    Cc: [EMAIL PROTECTED]
                    Subject: Re: Transmitting Patient Information via
                    Internet (Email)

                    Interesting solution.  My only question is how many of
                    these types of products will everyone have to manage in
                    order to send/receive secure attachments?  If I need
                    InTether to get your attachments and 4 or 5 or 10 other
                    proprietary solutions to get my other email partner's
                    attachments is that really going to work?  Adobe won
                    out in their market because the Feds went with them.
                    Perhaps something like that will happen with securing
                    email attachments.  The question is not (so much) does
                    the app work; rather it's how many different solutions
                    do I have to deal with in order to get my work done?


                    Jan Root



 
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