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I would like to especially direct this email to those plans that have
specific reporting needs for OB (maternity) care.

Our plan has been using the deleted code 59420 for providers to bill
antepartum visits and for reporting to Medicaid.  Per HIPAA we cannot use
deleted or homegrown codes.  Our providers would like for us to switch to
global billing.  However, global billing does not give us the dates that are
needed for Medicaid and other reporting needs.  If we go to Global billing
we will need to do 100% medical record review.

How are other plans handling this? 

Thanks,


Bert Bradley

-Original Message-----
From: Patricia Hamby [mailto:PHamby@;xantushealthplan.com]
Sent: Wednesday, October 23, 2002 9:49 AM
To: WEDI SNIP Privacy Workgroup List
Subject: RE: HIPAA-related privacy question (I think)


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This provider should realize that, as of October of 2003 Medicare will
accept claims electronically only (unless stringent conditions apply).  

Patricia Hamby
Project Manager, HIPAA Compliance
XANTUS Health Plan of Tennessee, Inc. 
3401 West End Ave., Suite 470
Nashville, TN 37203
(615) 463-1612, Office
(615) 279-1301, Facsimile

 -----Original Message-----
From:   Christiansen, John (SEA) [mailto:JohnC@;prestongates.com] 
Sent:   Tuesday, October 22, 2002 2:51 PM
To:     WEDI SNIP Privacy Workgroup List
Subject:        RE: HIPAA-related privacy question (I think)

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Jan has identified a problem  which has come up for me, too, in a somewhat
different variant: 
<<SNIP>
The setting:
1. The provider elects not to do HIPAA transactions and thus is a
non-covered entity.
<SNIP>
Issue: 
Because the provider is a non-covered entity (NCE), and, hence, is not
subject to the Privacy Rule, are payers going to include in their NCE
provider-payer contracts some kind of stipulation that the NCE provider
protect PHI?  (I don't think you can use a business associate contact to do
this: The provider cannot be a business associate because they are not
performing any of the payer's covered entity functions, yes?.)
<SNIP>>

#1 I think it is correct that the provider is not a business associate in
this scenario.

#2 Sec. .530(c) of the privacy rule requires CEs to implement "safeguards"
to protect PHI. BACs are required under secs. .502(e)/.504e) as
"satisfactory assurance" that the BA "will appropriately safeguard" PHI. 

So, shouldn't a CE (payer in Jan's scenario) get something equivalent to a
BAC for any use/disclosure of PHI by a NCE (provider in Jan's scenario), if
the payer is responsible for the protection of the PHI which is in the NCE's
control, even if they are not technically BAs?

Where else could this come up? E.g. plan NCQA accreditation audits of
provider records by third party auditors - they aren't BAs of the providers,
but can the providers afford to simply count on the auditors' ethics and
their contracts with other parties? I wouldn't recommend it, and when it
came up for a client I didn't - we required a separate agreement between the
auditors and my client. This same issue is also currently coming up in an
occupational medicine context, so this is clearly a "live one."
From: John R. Christiansen
Preston | Gates | Ellis LLP
701 Fifth Avenue, Seattle, Washington 98104
*Direct: 206.613.7118 - *Cell: 206.799.9388
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services.  They also are not intended to be used as a forum for personal
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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/.   These listservs should not be used for 
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