Toeing the line: health data, rate and form filing are insurers' top electronic compliance issues.For insurers dealing with technology-related compliance issues, these days it all comes down to two acronyms: HIPAA (Health Insurance Portability & Accountability Act of 1996, Public Law 104-191) Also known as the "Kennedy-Kassebaum Act," this U.S. law protects employees' health insurance coverage when they change or lose their jobs (Title I) and provides standards for patient health, and SERFF. HIPAA refers to the Health Insurance Portability and Accountability Act The Health Insurance Portability and Accountability Act (HIPAA) was enacted by the U.S. Congress in 1996. According to the Centers for Medicare and Medicaid Services (CMS) website, Title I of HIPAA protects health insurance coverage for workers and their families when of which mandates how an insured's private health data are handled SERFF is the propriety electronic rate and form filling system promoted by the National Association of Insurance Commissioners The National Association of Insurance Commissioners (NAIC) is an Internal Revenue Code Section 501(c)(3) non-profit organization which seeks to organize the regulatory and supervisory efforts of the various state insurance commissioners from around the United States. . The NAIC's System for Electronic Rate and Form Filing has been around in some form since 1997 and saw voluntary adoption in all 50 states and Washington, D.C., only in February. As the name implies, it is a Web-based rate and form-filing system. Though it might seem to make those filings easier, there's still some resistance, according to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. James V James V, king of Scotland James V, 1512–42, king of Scotland (1513–42), son and successor of James IV. His mother, Margaret Tudor, held the regency until her marriage in 1514 to Archibald Douglas, 6th earl of Angus, when she lost it to John . McMahan III, deputy commissioner of the Maryland Insurance Administration. "I know there are companies out there that can't stand SERFE I know it because I'm hearing from them directly," McMahan said. "I don't think anybody has any problems with filing electronically, because I hear companies ask us, 'Is there any way we can file (electronically) without using SERFF?' ... I know there are people out there who love it and people out there who hate it." Though slow to take off, SERFF has seen its use accelerate. Technically, it doesn't do anything that couldn't be accomplished through e-mail, but NAIC's proprietary software is secure and encrypted, and it allows insurers to send their filings to as many states as they want. The standardized format also gives insurers the uniformity for which they have been lobbying. Use picked up when the NAIC NAIC See National Association of Investors Corporation (NAIC). dropped the licensing fees companies paid to use the system in 2001; as of late July 2004, the NAIC reported that nearly 72,000 rate and form filings had been submitted so far during the year, with 11,700 of those filings in June alone. "It's a very valuable tool in my view," said Lawrence H. Mirel, commissioner of the District of Columbia District of Columbia, federal district (2000 pop. 572,059, a 5.7% decrease in population since the 1990 census), 69 sq mi (179 sq km), on the east bank of the Potomac River, coextensive with the city of Washington, D.C. (the capital of the United States). Department of Insurance, Securities and Banking. "It seems to me as though the more companies use it and the more states encourage its use, the more valuable it will become." SERFF is not mandatory, but some states that accept electronic filings will do so only through the SERFF system. And while SERFF may not be mandatory, complying with HIPAA is. The federal government enacted new rules in October 2003 focusing on the technical aspects of the electronic billing Electronic billing is the electronic delivery and presentation of financial statements, bills, invoices, and related information sent by a company to its customers. Electronic billing is also referred to as the following:
Confusion about the HIPAA regulations has spawned a cottage industry. The U.S. Department of Health and Human Services Noun 1. Department of Health and Human Services - the United States federal department that administers all federal programs dealing with health and welfare; created in 1979 Health and Human Services, HHS has a suboffice devoted to compliance issues, while a number of companies have popped up offering to help providers, insurers and other entities covered under the law comply with the law when dealing with patients' private data electronically. Some insurers also offer premium discounts on their professional liability policies to doctors, psychologists and other providers who take continuing education continuing education: see adult education. continuing education or adult education Any form of learning provided for adults. In the U.S. the University of Wisconsin was the first academic institution to offer such programs (1904). courses on how to comply with new HIPAA privacy rules. Key Points * Insurers are struggling to be sure their electronic handling of policyholders' private health data complies with HIPAA regulations. * Although the NAIC's System for Electronic Rate and Form Filing is designed to make filings easier, some insurers resist using the system. * Several agencies have been created to help insurers comply with HIPAA. Speaker Spotlight James V. McMahan III Deputy Commissioner, Maryland Insurance Administration "On the Regulatory Horizon" Lawrence H. Mirel Commissioner of the District of Columbia Department of Insurance, Securities and Banking "State and Local Regulatory Hot Spots hot spots acute moist dermatitis. : What to Know, What to Prepare or Now" Hyatt Regency Hotel, Inner Harbor Baltimore Oct. 17-19, 2004 www.efusion2004.com |
|
||||||||||||||||||||
Printer friendly
Cite/link
Email
Feedback
Reader Opinion