MGMA: Bills Include Transaction Mandates

HealthDataManagement Breaking News, October 13, 2009 – All three health reform bills in the U.S. House and both of the Senate proposals include provisions to mandate increased use of electronic standards-based administrative/financial transactions, according to an analysis by the Medical Group Management Association (MGMA), Englewood, Colo.

Most of the provisions would tighten or expand the HIPAA administrative simplification rules. Government affairs representatives of MGMA laid out the provisions during a session at the organization’s annual conference in Denver.

The House Energy and Commerce, Ways and Means, and Education and Labor Committees have reported reform bills. The Senate Health, Education, Labor and Pensions Committee has reported a bill. The Senate Finance Committee scheduled a vote on its reform bill for Oct. 13. Administrative simplification similarities and differences among the bills include:

• All five bills mandate use of machine-readable identification cards, a long-delayed standardized health plan identifier that was required under HIPAA, and standard “operating rules” to tighten the HIPAA transactions.
• The House bills require issuance and mandated use of long-delayed claims status attachment transaction standards. The Senate bills, as of Oct. 11, did not include this mandate.
• The House and Senate HELP bills mandate real-time transactions, such as claims submission and eligibility verification/benefits determination, which machine-readable ID cards would support. The Finance bill, as of Oct. 11, did not.

–Joseph Goedert

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