Doug:

Since it is not yet 2002-10-16 (or even 2003-10-16, assuming "WPS
Medicare B" has filed an ASCA exemption), any payer can restrict use of
electronic transactions any way they please (consonant with existing
law, if applicable).

I think something I just wrote to the ID & Routing group has some
relevance:

   When we discuss things here, please work under the assumption
   of an environment conforming to the HIPAA TCS and Privacy
   rules, more or less as they are promulgated today.  It would
   be too clumsy to preface everything we say with "If HIPAA TCS
   were still the law and compliance were required..."  Or, if
   you prefer using the Buckeye subjunctive, something like "If
   it *wuz* the law..."  Rest assured that if the HIPAA TCS Rule
   were abandoned, cancelled, de-promulgated, de-enacted,
   obliterated - or whatever - that probably a lot of things
   we've discussed.... won't have any relevance, let alone the
   force of law.

Kepa Zubeldia made the distinction between *now* and *then* (i.e.,
H-Day) quite clear in his posting last Thursday, when addressing
(artificial) requirements imposed by payers:

   ...if they really intended to modify the HIPAA  requirements
   by "requiring" something that is not used in the HIPAA guides
   even after 10/16/03, I am sure you can point to the Final Rule
   on  transactions where it says that you cannot do that.

I saw no exemptions in the HIPAA IGs or TCS Rule to the effect that you
can make any arbitrary restrictions you feel like as long as you're
Medicare. So, yes, it would seem that enforcing such arbitrary changes
to the X12 or HIPAA IG syntax rules would be non-compliant under HIPAA.

There's plenty of time before H-Day for WPS Medicare B to either 1) fix
their translator or processes, or 2) lobby the DSMO process to have the
HIPAA IGs themselves reflect the simpler interchange packaging they
desire.  I certainly would have no objection to option 2 (i.e., changing
the guide) - I just don't know why it wasn't chosen long before so folks
wouldn't be tempted to invent their own syntax restrictions in
"companion" guides.

William J. Kammerer
Novannet, LLC.
Columbus, US-OH 43221-3859
+1 (614) 487-0320

----- Original Message -----
From: "Doug Webb" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Wednesday, 17 July, 2002 12:55 PM
Subject: Re: Multiple ISA/IEA segments

See the WPS Medicare B Bulletin, January 2002 issue, pp 22-45 for an
example of this type of restriction. They explicitly state that they
will process only one transmission type (records group) per
transmission, only one GS-GE Functional Group within an ISA-IEA
interchange, and only one ST-SE set within a GS-GE Functional Group.
Does enforcing these restrictions make them non-complient? My software
will generate transmissions that comply with these restrictions because
it makes the program simpler.

----- Original Message -----
From: "William J. Kammerer" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Wednesday, 17 July, 2002 10:22 AM
Subject: Re: Multiple ISA/IEA segments


As Jonathan Allen has assured us, it is certainly valid X12 usage to
include multiple interchanges within a single transmission.  The HIPAA
IGs go even further, and confirm that it is perfectly permissible to
embed multiple transactions within a single functional group, or
multiple functional groups within a single interchange.  There are even
pictures of this in the appendices covering control structures!

So, certainly, if the implementation guides themselves say this is
acceptable, wouldn't a payer who refuses to accept, or rejects,
transactions packaged in Dana's example be non-compliant?  If folks
thought this might be too difficult to handle, shouldn't the HIPAA IGs
have said something else - or explicitly put restrictions on the number
of functional groups per interchange or the like?

Now, if I were cobbling together outbound transactions, I would probably
choose to use the simplest structure - in effect, the lowest common
denominator of a single transaction within a single functional group per
interchange - just to be safe.  I'm a considerate and thoughtful guy.
But it seems the recipient would have no business *demanding* the
simpler structure in any case; if the sender insisted on submitting a
multiply packed interchange, I can't see how the receiver could balk at
processing it:  she should either just fix her EDI translator or
manually break apart the transactions.  Or she could always participate
in the DSMO process to have the HIPAA IGs changed.

Jonathan suggests that there might be "trading partner considerations"
here.  What does that mean? Are we back to one-off interpretations of
implementation guides, where the dominant partner (usually the payer)
arbitrarily re-interprets the standard?  As it stands, there are
probably far too many places in the HIPAA IGs subject to partner
"negotiation."  For example, use of "extended" characters (see Appendix
A.1.2.3) like the at-sign (@) and lower-case characters are presumably
subject to partner negotiation! Just how the heck do you send an e-mail
address in the PER segment without using the at-sign?  Or do you have to
negotiate a tedious TPA just to use characters present on every
keyboard?  Does it grate you that you need "permission" to use
lower-case characters? I've used those since 2nd grade; why can't payers
handle them?  Wouldn't it be simpler for the HIPAA IG to say you can use
any character allowed by X12? - in effect, any graphic shared by EBCDIC
and ISO 8859 Latin-1 - so you should be able to handle names of those
with umlauted pretentiousness, like "Larry von B�low".   Hmmm... are the
sundry testing and certification vendors checking for this type of
stuff?

William J. Kammerer
Novannet, LLC.
Columbus, US-OH 43221-3859
+1 (614) 487-0320




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