As I understand the Electronic Transactions regulation ...
A) Voice and facsimile are not considered "a transaction" using
"electronic media". {most recently,
http://aspe.hhs.gov/admnsimp/q0055.htm}
B) Incentives may not be offered by a health plan for a provider to
use Direct Data Entry (DDE) versus a standard transaction. {45 CFR
162.925 (a) (4)}
C) A health plan's web site accessed by a provider would be
considered DDE. {45 CFR 162.103}
D) Thus far, I can find no definition of "incentive" nor clear
elucidation one way or the other that information presented on a
health plan's [DDE] web site in excess to that available via a
standard transaction constitutes an "incentive". Hopefully other
readers on this list can reference some DHHS materials that do.
Thus, the definition of "incentive" may become operational and
case-by-case.
-- For those providers who desire more information than is
communicated in a standard transaction and such information is
available on a health plan's web site, an implied incentive *may*
exist.
-- For those providers who do not need any additional information
beyond what is included in a standard transaction, no implied
incentive would be present.
-- [Similar analyses regarding implied incentives could also be
applied to response times for accessing a web site versus using a
standard transaction.]
-- Clearly, a health plan charging [in any manner] more to use a
standard transaction than to use their web site would constitute an
explicit incentive. {e.g., 45 CFR 162.925 (a) (2) and (5)}
Unless somebody can provide some references to additional official
materials, I guess we'll all just get to wait for clarification from
one of our DHHS sources.
Other analyses welcomed.
Dave Feinberg
Rensis Corporation [A Consulting Company]
206-617-1717
[EMAIL PROTECTED]
**********************************************************************
To be removed from this list, send a message to: [EMAIL PROTECTED]
Please note that it may take up to 72 hours to process your request.
