The Security Rule isn't final...yet, so it's impossible to "violate" it.
Furthermore, the banking network is not an open network, so encryption isn't
required.

Also, the proposed security rule contains the concept of "chain of trust"
which we have been told by HHS representatives will be brought into sync
with the privacy rule concepts and language, along with other proposed
security provisions.

Data and dollars together and data and dollars separate has always been an
issue for investigation, evaluation and resolution between the two trading
partners ever since the 820 became an approved X12 standard transaction used
for electronic funds transfer. Simply because some organizations have
already made the "business decision" to separate the data from the dollars
doesn't mean that that's the way it should be done for all organizations for
all time.

Rachel
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: Tuesday, April 23, 2002 8:49 AM
To: [EMAIL PROTECTED]
Subject: Re: HIPAA and the Banking System


Rachel:

I never kid, as you well know: I'm the most serious, pucker-faced person
around.  Payers should be careful where they send 835 EOBs containing
PHI.   Wouldn't it be a violation of the Security Rule if a bank - which
is not a covered entity and which most likely has no BA agreement with
the payer - receives an unencrypted EOB as part of a payment order from
that payer?  And who's going to get into big trouble? Not the bank, I
suspect, who is not in the healthcare business and was the innocent
recipient of the 835 dripping with PHI.  The payer is responsible for
knowing where its PHI is, and is culpable for having passed PHI to a
non-CE or entity with whom it has no BA agreement.

I'm no HIPAA security whiz, but then nobody would have to be on this
issue if banks didn't try to be all things to all people in the first
place. Even one who is not "an old structured programming mainframe
legacy programmer who was disciplined on modular approaches and
independence of functions" might intuit that payments be separated from
remittances, lest their mingling cause all sorts of havoc. Payments are
orders to your bank to pay someone else, and remittances are sent to the
provider to explain why a payment has been (or will be) made.  I suppose
payments and remittances might have something existentially to do with
each other, but wouldn't it be simpler to reconcile payments and
remittances in the A/R system at the provider's end?  Even if it isn't
simpler (than for the provider or his software vendor to have both the
dollars and the remittances arrive together), it fortunately isn't my
problem.

Anyway, banks don't even do the job of Clearinghouse or VAN very well:
the ACH system can't return X12 acknowledgements to the payer via the
payer's bank, which was the original reason X12F Finance doesn't want
997s to report on IG compliance violations.

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

----- Original Message -----
From: "Rachel Foerster" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Monday, 22 April, 2002 05:17 PM
Subject: HIPAA and the Banking System


William,


It's not a question of whether the banks will insist on providing
clearinghouse-type services to their customers.....many are today and
have been for years! The banks just aren't aware of what's heading their
way as a result of HIPAA.

Certainly you're kidding when you say it's simpler for the providers to
reengineering their systems....what planet are you on! There are
literally hundreds of patient accounting/practice management systems
vendors serving the industry. This would not be a trivial effort!

Rachel

-----Original Message-----
From: William J. Kammerer [mailto:[EMAIL PROTECTED]]
Sent: Monday, April 22, 2002 3:29 PM
To: [EMAIL PROTECTED]
Subject: Re: questions on the appropriate way to reply when there
areerror in a transaction request


There are two separate issues:

(1) Payments and electronic funds transfer.  The exclusion Sujay refers
to probably applies to the funds transfer and check clearing functions.
Technically, even though minimal PHI is revealed in a payment (either by
check or EFT) - such as possibly the name of the patient-subscriber and
that of the provider - because of the exclusion, banks don't come under
HIPAA privacy rules.

(2) But if banks inexplicably insist on getting into the Clearinghouse
and VAN business by relaying PHI-laden EOBs, then it stands to reason
they become an entirely different animal (either a covered entity, or a
BA with the need to execute BA agreements with every other bank,
provider or payer they come into contact with).

Isn't it just simpler all around for payers and providers to reengineer
their applications to (1) just send the EOB to the payee directly or
through a CE like a clearinghouse, and (2) separately order the bank to
transfer funds?

Don't you remember the little sign that retailers often use to
discourage checks? "We have an agreement with the bank:  They don't sell
ice cream, and we don't cash checks."

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




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