NOV 21, 2011 5:27pm ET

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ANSI, HL7 Ask to Lead Development of Attachments Operating Rule

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Standards development organizations ANSI ASC X12 and Health Level Seven International have requested being jointly named as the entity to develop "operating rules" for the electronic HIPAA claims attachments transaction.

The organizations made the request on Nov. 17 through testimony to the National Committee on Vital and Health Statistics, an advisory board to the Department of Health and Human Services.

The Affordable Care Act mandates development of operating rules to make HIPAA transactions more standardized. The Committee on Operating Rules for Information Exchange within CAQH, an alliance of payers and trade associations, is developing operating rules for a number of the transactions.

The reform law authorized the National Committee on Vital and Health Statistics to recommend entities to create operating rules. NCVHS in February recommended CORE for non-retail pharmacy transactions and the National Council for Prescription Drug Programs for pharmacy transactions.

Now, ASC X12 and HL7 are making their pitch to be the entity for the reform law-mandated claims attachment transactions. Answering a series of questions from NCVHS to the industry, the organizations acknowledged they would be jointly pursuing designation as an operating rules authoring entity. The organizations note that they have long collaborated on the claims attachment and other transactions, and project plans, processes and liaisons already are in place.

 

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Looking to build better care coordination, health systems are buying physician groups in droves. Making the deal work, however, requires careful management on the I.T. front.

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