Recommendations provided for Committee on Operation Rules for Information Exchange (CORE) standards refinement and clarification
WEDI (@WEDIonline), the nation’s leading authority on the use of health IT to create efficiencies in healthcare information exchange, presented testimony on Feb. 16, 2016 before the Department of Health and Human Services, National Committee on Vital and Health Statistics (NCVHS), Subcommittee on Standards. Board members of WEDI presented testimony on the proposed new rules from the Committee on Operating Rules for Information Exchange (CORE) and their impact on HIPAA transactions, including standards for attachments and prior authorization of claims.
WEDI recognizes that there continues to be a need for greater adoption of the HIPAA transactions, and feels that Operating Rules, as a supplement to the ASC X12N transactions, are an important tool that can help aid the industry in moving forward with health IT. According to WEDI’s Feb. 16 testimony: “The ultimate goals of administrative simplification are to improve the accuracy, efficiency, and cost‐savings of all transactions. The Phase IV Operating Rules are intended to clarify and enhance how transactions should be used in practice by defining connectivity, authentication, identification, standard acknowledgments, and system availability. However, WEDI continues to have concerns that the published Phase IV rules impose more restrictive connectivity requirements to an industry already burdened by competing health IT implementation timelines and priorities. The Phase IV operating rules focus on infrastructure and connectivity, which does play a role in achieving these goals.”
WEDI’s observations and recommendations touched on critical issues such as inconsistency of requirements across phases, variance in privacy and security, overloading of industry resources and confusion about certification provisions. For the full details on recommendations, read the testimony brief.
“While WEDI understands the need and desire to move the industry forward with the adoption of operating rules for claims, we urge HHS to work with WEDI to monitor challenges and surveying industry readiness,” said Jean Narcisi, Chair of the WEDI Board of Directors and Director of Dental Informatics for the American Dental Association. “It is recommended that a system be developed to capture testing and implementation issues in order to provide the industry with a common database of issues that can be consulted. WEDI has a longstanding history of working collaboratively with HHS in offering joint educational programs to help educate stakeholders on regulatory changes. We look forward to continuing this relationship to further develop educational briefings and webinars to help key stakeholders learn about the operating rules, transactions and standards.”
WEDI has previously provided testimony on Operating Rules in 2010, 2011 and 2015, and will continue to monitor and update HHS on any pertinent industry regulatory changes in the future.
About WEDI
The Workgroup for Electronic Data Interchange (WEDI) is the leading authority on the use of health IT to improve healthcare information exchange in order to enhance the quality of care, improve efficiency, and reduce costs of our nation’s healthcare system. WEDI was formed in 1991 by the Secretary of Health and Human Services (HHS) and was designated in the 1996 HIPAA legislation as an advisor to HHS. WEDI’s membership includes a broad coalition of organizations, including: hospitals, providers, health plans, vendors, government agencies, consumers, not-for-profit organizations, and standards development organizations. To learn more, visit their website and connect with them on Twitter, Facebook and LinkedIn.
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