Yes, but what happens when someone complains to CMS about CMS??? That, I think is a good question.
-----Original Message----- From: William J. Kammerer [mailto:[EMAIL PROTECTED]] Sent: Wednesday, October 16, 2002 1:12 PM To: [EMAIL PROTECTED] Subject: Re: FW: [HHSPRESS] HHS RELEASE--HIPAA STANDARDS Theresa: What do you mean by CMS "policing itself"? I assume it's subject to the law of the land, and can't brutalize and detain TCS violators! If Mr. King-Shaw actually said such a thing (i.e., that the TCS enforcer would be "anybody but us"), it was perhaps just modesty: what bureaucracy turns down more "responsibility"? Anyway, the HHS press release said that the "[TCS enforcement] process will be primarily complaint driven," which makes perfect sense. Long before any provider complains to CMS, I'm sure she will try to work it out with the payer. And yes, I think almost all complaints will originate from providers: if a claim is not HIPAA "compliant," theoretically, the payer merely needs to reject it without running afoul of prompt pay laws - though I doubt any payers would go to the trouble to do so, since how would they know if the provider did or didn't file an ASCA extension?? On the other hand, at least after the "ASCA" dust has settled in 2003, providers have a real need - getting paid - to have the payers abide by the TCS rules. I'm having a hard time imagining a case (even after 2003) where a payer would "snitch" on a provider; anyone have counter-examples? I doubt CMS will be involved in any "enforcement" at all for the first couple of years - it will probably just render "opinions" in the form of FAQs which all parties will try to abide by in good faith. My "Gartneresque" prediction: the ASCA extensions are probably irrelevant (.8 probability). There's apparently no mechanism to see which partners did or didn't file, so HIPAA exchanges will depend on simply asking partners if they're "ready." William J. Kammerer Novannet, LLC. Columbus, US-OH 43221-3859 +1 (614) 487-0320 ----- Original Message ----- From: <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Wednesday, 16 October, 2002 01:24 PM Subject: Re: FW: [HHSPRESS] HHS RELEASE--HIPAA STANDARDS Anyone wonder how CMS will police itself? Mr. King-Shaw is also on record as saying at last year's HIPAA summit, when pondering the question of who would be the TCS enforcer, "I say anybody but us. We have enough problems with HIPAA as it is." Theresa Defino Editor Practical Guidance on HIPAA and E-Health For the Physician Practice 301-738-3721 ********************************************************************** To be removed from this list, send a message to: [EMAIL PROTECTED] Please note that it may take up to 72 hours to process your request. ====================================================== The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited. ********************************************************************** To be removed from this list, send a message to: [EMAIL PROTECTED] Please note that it may take up to 72 hours to process your request. ====================================================== The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.
