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WebMD Releases White Paper Urging HHS To Adopt 'Rational Roll-Out
Plan' For HIPAA
ELMWOOD PARK, N.J., July 19 /PRNewswire-FirstCall/ -- WebMD Corporation today
released a White Paper on the implementation of the Health Insurance
Portability and Accountability Act (HIPAA) that concludes the law's
Administrative Simplification provisions are increasing complexity and costs
for healthcare providers and payers across the country. The White Paper, which
is the result of WebMD's analysis of HIPAA implementation nationwide,
identifies concrete steps that the U.S. Department of Health & Human Services
can take to steer the implementation back on course, through a "rational roll-
out plan."
The paper, entitled "HIPAA Implementation: The Case for a Rational Roll- Out
Plan," explores how the law -- as implemented -- has not advanced HIPAA's
promise of simplification, standardization and reduced cost, but rather has had
the reverse effect. It states that Administrative Simplification is at risk
for three reasons: 1) a lack of uniformity in implementing the standards; 2) a
failure by the healthcare industry to implement all of the standard
transactions to enable a "two-way street" for information exchange between
payers and physicians; and, 3) confusing and unnecessary data content
requirements.
"HIPAA has achieved only a fraction of its potential because of the demands of
the law and the ways in which it has been interpreted and implemented," said
Roger Holstein, CEO, WebMD Corporation. "Our hope is that this White Paper
will encourage all parties who share a stake in HIPAA's successful
implementation to begin a dialogue in search of practical real- world solutions
that will help bring about industry-wide success in achieving HIPAA's promise."
The White Paper reports that although health care claims are widely exchanged
in the HIPAA standard format, the other standard transactions lag far behind.
Only 3.1% of the payers to which WebMD transmits claims are engaging in all of
the HIPAA standard eligibility, claims status, and remittance advice
transactions through WebMD.
Furthermore, the Paper explores how the lack of acknowledgement of receipt of
information provided from a healthcare provider to a payer has emerged as an
ongoing provider issue. To the extent that payers acknowledge receipt of a
claim at all, the format is not uniform, and as a result, providers are not
able to efficiently accept, process and respond to the information included in
the acknowledgment.
The White Paper urges the US Department of Health and Human Services (HHS), and
the agency's Centers for Medicaid and Medicare Services, to take action through
a series of course corrections, including:
* Continuing the contingency period under which trading partners are
operating under contingency plans.
* Defining a HIPAA standard claims transaction to include only that
content necessary for the adjudication of the claim and enforcing the
content requirements only as a cap on what may be contained in a covered
transaction.
* Coordinating a rational, industry-wide roll-out that promotes the
exchange of all HIPAA standard transactions, not just claims.
The White Paper suggests that CMS' actions are vital to ensuring that the HIPAA
objectives of cost savings and increased efficiency are achieved and that
success or failure here will have significant implications for the country's
National Health Information Infrastructure.
WebMD Envoy(R) conducts more HIPAA transactions than any other private entity.
In total, WebMD processes more than 3.0 billion transactions on an annualized
basis for 300,000 physicians, hospitals, dentists, labs and pharmacies,
submitting to more than 1,500 payer connections. Although fewer than 19% of
the medical claims that we receive are in HIPAA format, 70% of the medical
claims and 80% of all transactions going out to payers are in HIPAA format.
For a copy of the complete White Paper, please contact Jennifer Meyer at or
visit http://www.webmd.com/corporate/index.html.
ABOUT WEBMD
WebMD Corporation provides services that help physicians, consumers, providers
and health plans navigate the complexity of the healthcare system. Our products
and services streamline administrative and clinical processes, promote
efficiency and reduce costs by facilitating information exchange, communication
and electronic transactions between healthcare participants.
WebMD Health is a leading provider of online information, educational services
and communities for physicians and consumers. WebMD Practice Services is a
leading provider of physician practice management software and related
services. WebMD Envoy is a leader in payer and healthcare provider transaction
processing and reimbursement cycle management services.
Porex is a developer, manufacturer and distributor of proprietary porous
plastic products and components used in healthcare, industrial and consumer
applications.
All statements contained in this press release, other than statements of
historical fact, are forward-looking statements. These statements are based on
WebMD's current plans and expectations and involve risks and uncertainties,
including those described in our SEC filings.
DATASOURCE: WebMD Corporation
CONTACT: Jennifer Meyer of WebMD Corporation, ,
Media: +1-212-624-3912, Investors: +1-201-414-2002
Web site: http://www.webmd.com/
http://www.webmd.com/corporate/index.html