The proposal provides a “valuable tool to support the electronic submission of healthcare information,” said CMS Administrator Chiquita Brooks-LaSure. It would reduce provider burden and could save more than $450 million a year.
The Centers for Medicare and Medicaid Services on Monday, put forth a new proposed rule that would modify HIPAA to better support both claims and prior authorization transactions – providing standards for electronic signatures to be used in conjunction with healthcare attachments transactions.
WHY IT MATTERS
The proposed rule is titled Adoption of Standards for Health Care Attachments Transactions and Electronic Signatures, and Modification to Referral Certification and Authorization Transaction Standard (CMS-0053-P).
If finalized, it would promote standards adoption for transactions with attachments for prior authorizations, including medical charts, X-rays and provider notes that document physician referrals. The modifications to HIPAA would also include a standard for the referral certification and authorization transaction.
The proposed rule could save $454 million a year in administrative costs, according to CMS, and is another instance of the agency’s efforts to reduce paperwork burdens and streamline provider and patient experience.
THE LARGER TREND
Much more detail on the proposed changes can be found here. The rule “aims to support health care claims and streamline prior authorization transactions,” according to CMS, and “would help make the process of submitting and adjudicating healthcare claims more efficient by providing structured, standardized electronic data to payers.”
Additionally, by adopting a modification to the standard for the referral certification and authorization transaction, the proposed rule “could help reduce potential barriers to adopting value-based payments and significantly easing unnecessary administrative costs and burdens on providers and health plans.”
The CMS proposal is available to review at the Federal Register. Comments may be submitted until March 22, 2023.
“The AHA supports establishing a standard for attachments to reduce the administrative burdens facing clinicians, and we look forward to providing robust commentary after analyzing the rule’s specifics,” said Terrence Cunningham, director of administrative simplification policy at the American Hospital Association..
ON THE RECORD
“The proposals in this rule would provide a valuable tool to support the electronic submission of health care information,” said CMS Administrator Chiquita Brooks-LaSure, in a statement.
“Healthcare providers are often forced to use manual processes such as mail, fax, or internet web portals when they respond to requests from health plans, leading to delays and less time for patient care. These important steps would promote more consistent and reliable communications among the partners involved in health care transactions, improving the care experience for all.”
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