Marcalle,

Your assumption below that a provider submitting an extension under ASCA
automatically declares itself to be a covered entity is not true. CMS/DHHS
has repeatedly made this statement so that potentially covered entities,
especially providers, do not feel inhibited from filing such an extension
request.

I believe that this is also addressed in the various CMS FAQs relative to
ASCA.

Rachel Foerster

-----Original Message-----
From: Marcallee Jackson [mailto:[EMAIL PROTECTED]]
Sent: Sunday, October 13, 2002 12:22 PM
To: [EMAIL PROTECTED]
Subject: RE: HIPAA Exemption


Jonathan-

I am not aware of a definitive answer to this but it would seem that if
a provider stops all electronic transactions prior to the deadline of
October 16, 2002, they could exempt themselves from HIPAA.  To be
granted an extension, a provider has to file a work plan for achieving
compliance with the Transaction and Code Sets (TCS) rule.  I would think
a provider who files for the extension has acknowledged itself as a
Covered Entity (CE) with a plan for compliance.  Also, that provider
would need to be compliant with the Privacy rules by April of 2003.  So
I would say that reverting to paper after filing for the extension would
not exempt the provider.

For a small provider, reverting to paper for claims might be a workable
short term solution for compliance with TCS but for most, it is not a
realistic long term strategy for full exemption from HIPAA.  Using any
electronic HIPAA transaction, including in a Direct Data Entry (DDE)
scenario, would cause the provider to meet the definition of a CE under
HIPAA and require compliance with all HIPAA's rules.   That would mean
the provider could never check eligibility on a payer's Web site or
complete other tasks online like checking claim status or requesting a
referral.  That could turn out to be a big drag very soon.  In addition,
many payer's are expected to follow Medicare's lead and require the use
of electronic transactions.  Payers are also not expected to support
non-compliant code sets for long so even providers conducting paper
transactions will have work to do to convert.  Finally the cost to the
provider who does not conduct HIPAA transactions electronically could
easily exceed the cost of compliance.

I know of a tool available for free online that allows a provider to
calculate the cost of manual transactions and compare those against the
cost of electronic.  I used the tool to calculate the savings of a
provider who sees 125 patients a week.  The resultant savings were over
$40,000 a year.  Plus or minus 20%, the number is pretty compelling.
If you would like, email me directly and I'll send a link to the tool.

A better plan might be for the provider to acknowledge itself as a CE
and file for an extension by quickly developing a high level work plan.
Next the provider should purchase an inexpensive tool for Privacy and
Security compliance.  There are many available today.  Complying with
these regulations really isn't all that difficult for a small provider.
Then, the provider can check out its options for transactions and, if it
decides its only option for claims is paper, go ahead and send them that
way for as long as they need to or can.  But this would still allow the
use of other electronic transactions like DDE eligibility, claim status,
etc.

Hope that helps.

Marcallee Jackson
Long Beach, CA
562-438-6613

-----Original Message-----
From: Jonathan May [mailto:[EMAIL PROTECTED]]
Sent: Friday, October 11, 2002 5:09 AM
To: [EMAIL PROTECTED]
Subject: RE: HIPAA Exemption

Thank you for your responses, but just to clarify - I understand the
fewer
than 10 FTE exemption. I am unclear as to whether this practice, who
currently submits electronic claims to Medicare will be exempt from
HIPAA
requirements if they stop these submissions prior to October 15, 2002?
What
if they file for an extension, but stop their electronic submissions
prior
to October 15, 2003?

Thanks again.





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