I only know what I've read - and it does kind of conform to the way I
imagine things should work.  For example, see HHS Response to Comments
http://www.bricker.com/attserv/practice/hcare/hipaa/164.501p.asp -

Definitions - Payment - � 164.501

Because a financial institution does not require the remittance advice
or premium data parts to conduct funds transfers, disclosure of those
parts by a covered entity to it (absent a business associate arrangement
to use the information to conduct other activities) would be a violation
of this rule.

Under the proposed Security Rule, the ACH system and similar systems
would have been considered "open networks" because transmissions flow
unpredictably through and become available to member institutions who
are not party to any business associate agreements (in a way similar to
the internet). The proposed Security Rule would require any protected
health information transferred through the ACH or similar system to be
encrypted.

William J. Kammerer
Novannet, LLC.
+1 (614) 487-0320

----- Original Message -----
From: "Rachel Foerster" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Monday, 22 April, 2002 05:01 PM
Subject: RE: questions on the appropriate way to reply when there are
error in a transaction request


Jan,


It's a mistake to believe that the banks translate the X12 interchange
into an ACH format. That's simply not true. When an X12 interchange is
sent to a bank with payment instructions and table 2 data (RA stuff) the
entire interchange is dumped into a CTX format. It's just a wrapper
around the X12 stuff and no translation takes place.

When the banks perform this activity with no other value-add services
being done either on behalf of the payee or payer, they are simply a
conduit and they are neither a business associate or a covered entity
under HIPAA.

On the other hand, if the bank provides additional services, such as
reformatting the received table 2 data in an 835 into another format and
then forwards that on to its customer, the provider, it is acting as a
clearinghouse, thus becoming both a covered entity and a business
associate. I also believe the same would be true if the bank received
the 835 table 2 data and put it on paper to send to its customer.

Encrypting is the entire interchange is not an option if sending the
complete 835 through the banking system. The 835 table 1 data must be in
the clear since this is where all of the payment instructions are found.
In this case, then encyrpting table 2 would be the only option for
ensuring the confidentiality of the PHI. But, this approach, of course,
has all sorts of issues and challenges.

And deciding to separate the data from the dollars has its own set of
issues as well, not the least of which is the receiving system's ability
to receive the 835, recognize that its RA only, that payment will be
made electronically and thus to suspend posting of the RA until notified
by the bank that the funds have been received, matching the 835 to the
funds received notice from the bank, etc.

Rachel




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