This is not a HIPAA Myth, look at ...
Section 1176 of the Act establishes civil monetary penalties for violation
of the provisions in part C of title XI of the Act, subject to several
limitations. Penalties may not be more than $100 per person per violation
of a provision, and not more than $25,000 per person per violation of an
identical requirement or prohibition for a calendar year. With certain
exceptions, the procedural provisions in section 1128A of the Act, ''Civil
Monetary Penalties,'' are applicable to imposition of these penalties.
Section 1177 of the Act established penalties for any person that knowingly
misuses a unique health identifier, or obtains or discloses individually
identifiable health information in violation of this part. The penalties
include: (1) A fine of not more than $50,000 and/or imprisonment of not
more than 1 year; (2) if the offense is ''under false pretenses,'' a fine
of not more than $100,000 and/or imprisonment of not more than 5 years; and
(3) if the offense is with intent to sell, transfer, or use individually
identifiable health information for commercial advantage, personal gain, or
malicious harm, a fine of not more than $250,000 and/or imprisonment of not
more than 10 years. We note that these penalties do not affect any other
penalties that may be imposed by other federal programs.
Will HHS be this severe on October 17th ? I don't imagine so, but it is
all laid out for them to use to enforce the Rule. Here in Arizona you'd
get to wear a lovely pinky-orange jumpsuit, live in a tent, and pay for
your meals! I know the prospect of living in a tent here is making me
quite diligent in getting our customers compliant.
Marsha
Verizon Information Technologies
Managed Care Division
Phoenix, AZ
Home of the Back To Back NL West Champion ARIZONA DIAMONDBACKS
Phone - 602.678.6042
Fax - 602.678.6331
E-mail - [EMAIL PROTECTED]
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"William J.
Kammerer" To: "WEDI SNIP Transactions
Workgroup List"
<[EMAIL PROTECTED] <[EMAIL PROTECTED]>
et.com> cc:
Subject: Re: Payors not compliant
effective on provider
06/04/2003 09:12
AM
Please respond to
"William J.
Kammerer"
Is this more HIPAA hysteria? Since when would a violation of the TCS
rule - however purposeful - result in a prison sentence?
William J. Kammerer
Novannet, LLC.
Columbus, US-OH 43221-3859
+1 (614) 487-0320
----- Original Message -----
From: "John Sherman" <[EMAIL PROTECTED]>
To: "WEDI SNIP Transactions Workgroup List"
<[EMAIL PROTECTED]>
Sent: Wednesday, June 04, 2003 11:51 AM
Subject: RE: Payors not compliant effective on provider
After November 15, 2003, Providers still have the option of submitting
claims on paper, but health plans must accept standard transactions from
providers if the provider chooses to submit claims electronically. If
the provider submits electronically it must be in the standard format
and content. Health plans and providers may use healthcare
clearinghouses to assist them if they so choose.
The risk to the provider of submitting paper claims is that they may not
be paid as quickly as they would if they submitted electronically.
The plan not being compliant should be a red flag to the provider. The
plan is facing fines, possible prison for executives who ignored the law
and the providers timely payment for claims is at risk.
John Sherman
HIPAA Project Manager
Corporate Benefit Services of America
(952)593-6478 Fax (952)582-2849
[EMAIL PROTECTED]
-----Original Message-----
From: Brenda K. Burton [mailto:[EMAIL PROTECTED]
Sent: Wednesday, June 04, 2003 10:20 AM
To: WEDI SNIP Transactions Workgroup List
Subject: Payors not compliant effective on provider
Please, if somebody could clarify/refer me to the answer (I'm sure this
has been dicussed):
If a payor is unable to handle electronic transactions by October 16,
may they revert to paper unilaterally?
What other A/R risks are present for the healthcare provider if a
particular payor is not able to be compliant by October 16?
Looking for contingency planning reasons.
Thanks!
Brenda
Brenda K. Burton
MEDEXTEND
877-491-7650
Join us for discussion at:
http://groups.yahoo.com/group/compliantbilling/join
Available on Instant Messenger as: medextend
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