The consolidated Senate health reform bill includes language to significantly tighten the HIPAA transaction standards and other administrative simplification provisions.

Senate Majority Leader Harry Reid has released the 2,074-page bill, which marries provisions of legislation from the Health and Finance Committees. The Patient Protection and Affordable Care Act is available at

The bill would mandate use of "operating rules" that payer advocacy organization CAQH has championed to standardize the HIPAA standards. The goal is to make financial and administrative transactions as easy to conduct as an ATM transaction. Further, the set of operating rules for electronic funds transfers and remittance advice transactions "shall allow for automated reconciliation of the electronic payment with the remittance advice," according to the bill. The bill also calls for adoption of the long-delayed health plan identifier.

The legislation carries compliance deadlines from 2013 to 2016 for various transactions. Insurers would have to certify to the Department of Health and Human Services that they comply with the operating rules.

The rules for eligibility and claims status transactions would allow for the use of a machine-readable card, under the legislation. But the bill appears not to mandate the cards or real-time transactions, as have previous versions of reform legislation. Nor does the consolidated Senate reform bill appear to mandate the Food and Drug Administration to implement a unique medical device identification system, called UDI.

--Joseph Goedert

Register or login for access to this item and much more

All Health Data Management content is archived after seven days.

Community members receive:
  • All recent and archived articles
  • Conference offers and updates
  • A full menu of enewsletter options
  • Web seminars, white papers, ebooks

Don't have an account? Register for Free Unlimited Access