The following is from the preamble to the final privacy rule regarding
financial institutions beginning on page 82570:

Response: We interpret section 1179
of the Act to mean that entities engaged
in the activities of a financial
institution, and those acting on behalf of
a financial institution, are not subject to
this regulation when they are engaged in
authorizing, processing, clearing,
settling, billing, transferring,
reconciling, or collecting payments for a
financial institution. The statutory
reference to 12 U.S.C. 3401 indicates
that Congress chose to adopt the
definition of financial institutions found
in the Right to Financial Privacy Act,
which defines financial institutions as
any office of a bank, savings bank, card
issuer, industrial loan company, trust
company, savings association, building
and loan, homestead association,
cooperative bank, credit union, or
consumer finance institution located in
the United States or one of its
Territories. Thus, when we use the term
��financial institution�� in this
regulation, we turn to the definition
with which Congress provided us. We
interpret this provision to mean that
when a financial institution, or its agent
on behalf of the financial institution,
conducts the activities described in
section 1179, the privacy regulation will
not govern the activity.

If, however, these activities are
performed by a covered entity or by
another entity, including a financial
institution, on behalf of a covered
entity, the activities are subject to this
rule. For example, if a bank operates the
accounts payable system or other ��back
office�� functions for a covered health
care provider, that activity is not
described in section 1179. In such
instances, because the bank would meet
the rule�s definition of ��business
associate,�� the provider must enter into
a business associate contract with the
bank before disclosing protected health
information pursuant to this
relationship. However, if the same
provider maintains an account through
which he/she cashes checks from
patients, no business associate contract
would be necessary because the bank�s
activities are not undertaken for or on
behalf of the covered entity, and fall
within the scope of section 1179. In part
to give effect to section 1179, in this rule
we do not consider a financial
institution to be acting on behalf of a
covered entity when it processes
consumer-conducted financial
transactions by debit, credit or other
payment card, clears checks, initiates or
processes electronic funds transfers, or
conducts any other activity that directly
facilitates or effects the transfer of funds
for compensation for health care.

We do not agree with the comment
that section 1179 of the Act means that
the privacy regulation�s requirements
cannot apply to the activities listed in
that section; rather, it means that the
entities expressly mentioned, financial
institutions (as defined in the Right to
Financial Privacy Act), and their agents
that engage in the listed activities for the
financial institution are not within the
scope of the regulation. Nor do we
interpret section 1179 to support an
exemption for disclosures to financial
institutions from the minimum
necessary provisions of this regulation.

Rachel Foerster
Principal
Rachel Foerster & Associates, Ltd.
Professionals in EDI & Electronic Commerce
39432 North Avenue
Beach Park, IL 60099
Phone: 847-872-8070
Fax: 847-872-6860
http://www.rfa-edi.com


-----Original Message-----
From: William J. Kammerer [mailto:[EMAIL PROTECTED]]
Sent: Monday, April 22, 2002 5:11 PM
To: [EMAIL PROTECTED]
Subject: Re: questions on the appropriate way to reply when there are
error in a transaction request


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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