[ Thursday, July 24, 2003 ]


Transaction and Code set guidance:

HHS has issued what it calls its final guidance on compliance with the transaction and code sets standards after the October 16 deadline. Unlike Privacy and Security, TCS is enforced by CMS rather than OCR (hey, at least it's not OIG!). For the acronymically challenged, the transaction and code sets rules will be enforced by the Centers for Medicare and Medicaid Services, rather than the Office of Civil Rights or the Office of the Inspector General. The enforcement environment will be complaint driven, and the covered entity subject to the complaint will be given the opportunity to show compliance, show good faith efforts to comply, and/or show a corrective action plan for attaining compliance. It sure looks reasonable.

In determining good faith efforts, CMS will look at sustained activities like external testing , outreach, and whether trading partners are impeding progress. For CMS, proof of good faith efforts will show in the documentation; if you're really trying but not making progress, at least document your efforts so you'll have something to show if the regulators come a-knocking.

One thing is clear, though. Regardless of the warning that this will be a train wreck, HHS is reiterating that the deadline is the deadline. There will be soft-handed enforcement, but there will be no extensions.

Jeff [3:04 PM]

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