HIPAA Helps Outsourcing Company

NU Online News Service, May 17, 7:23 p.m. – Antares Management Solutions L.L.C. is one of the companies that really likes the Health Insurance Portability and Accountability Act of 1996.

Health insurers and health maintenance organizations are shaking their heads at the technology-related regulations pouring out of Washington as a result of HIPAA.

The carriers’ confusion represents a huge opportunity for Antares and other companies that administer claims for health carriers.

For health carriers, HIPAA “is more expensive than Y2K was,” says Edward Hartzell, the founder and chief executive of the Westlake, Ohio, company. “We’re starting to get a lot of calls.”

Congress enacted the technology-related sections of HIPAA in an effort to persuade doctors, hospitals and health carriers to move toward adopting a universal data communications system. Congress also added health data privacy and security provisions, to give consumers confidence in the health data communications system.

Lawmakers hoped the HIPAA technology provisions would help eliminate the billions of dollars the U.S. health finance system spends each year on shuffling paper claims.

The HIPAA privacy requirements tend to attract the most attention, but implementing the less controversial data standards is proving to be far more expensive, Hartzell reports.

HHS is putting the finishing touches on a standard data format. Originally, it told health carriers they would have to be capable of handling transactions submitted in the standard format Oct. 16. Now, HHS is saying carriers can push the deadline back to October 2003, if they file an acceptable HIPAA compliance plan by Oct. 16, 2002.

Hartzell has watched many carriers put off serious compliance efforts in the hope that the Bush administration would kill the requirements.