Del,

I think the first most important test to determine whether this constitutes
DDE under HIPAA is to ask who's using it? That is, if it is health care
providers who are accessing eligibility and claims status information, then
it falls under the DDE exception as set forth in

? 162.923 Requirements for covered entities.

(b) Exception for direct data entry transactions. A health care provider
electing to use direct data entry offered by a health plan to conduct a
transaction for which a standard has been adopted under this part must use
the applicable data content and data
condition requirements of the standard when conducting the transaction. The
health care provider is not required to use the format requirements of the
standard.

Key points:
1. a health care provider uses the system
2. the system is offered by a health plan

If this doesn't pass this test, then it's my opinion that it's not DDE as
defined by HIPAA.

Additionally, the Department of Justice has not weighed in on anything yet
regarding enforcement/compliance with HIPAA.

Rachel Foerster
Principal
Rachel Foerster & Associates, Ltd.
39432 North Avenue
Beach Park, IL 60099
Voice: 847-872-8070
Fax: 847-872-6860
eMail: [EMAIL PROTECTED] <mailto:rachel@;rfa-edi.com>
http://www.rfa-edi.com


-----Original Message-----
From: Del Texley [mailto:dtexley@;lipa.net]
Sent: Thursday, October 17, 2002 12:03 PM
To: [EMAIL PROTECTED]
Subject: State Online system



Our state has an online system to look at eligibility and
claims/encouter data.  It's just a mainframe/telnet session via dialup,
leased line or internet.

At a meeting yesterday we were given information about some minor
changes to the system and of course it was asked what would be
replacing it for HIPAA compliance.  Imagine our surprise when the
state informed us the system would continue in it's current form
indefinately.

When quizzed about HIPAA issues we were told the Dept. of Justice
had determined that the system was "not DDE" because "no claims
data was input via the system" and was not performing HIPAA
transactions because "no files were being transferred" and was
therefore exempt from HIPAA.

The stand of the contractors in the meeting was that regardless of
whether the system was or wasn't DDE (which it is), the system was
transmitting PHI in an electronic format and therefore was required to
adhere to privacy requirements, such as encryption of the data.

I'm gathering information to send to the contact person as part of a
request to revisit the classification of this system.  Anybody have
some suggestions on documentation sources or comments on the
situation?

Thanks


Del Texley
LIPA Information Systems
(541) 484 6430



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