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Legislation Requires Development of Standards and Protocols for Electronic Enrollment, and Eligibility Notification and Verification

Bernadette M. Broccolo, Daniel F. Gottlieb, and Jean Marie R. Pechette, for HealthLeaders Media, April 22, 2010

HHS must ensure that enrollment HIT developed through such grants is made available to state and local governments and other entities meeting qualification standards determined by HHS.

Effect on HIPAA Standardized Transactions and Meaningful Use Requirements
Whether and to what extent the enrollment standards, protocols and HIT will affect the HIPAA-standardized health plan eligibility verification transaction, the requirements for EHR technology to be certified as capable of supporting "meaningful use" under the HITECH Act's Medicare and Medicaid EHR incentive programs, and the meaningful use requirements for eligible providers remains to be seen.

It would be prudent for HHS to make enrollment standards and protocols consistent or aligned with the incentive programs' EHR technology certification criteria and meaningful use requirements in the functional areas covered by both (e.g., eligibility, interoperability and security) to maximize the significant investment the federal government is making to facilitate the adoption of a nationwide health information network.

It will also enhance HIT vendors' ability to develop efficiently and expeditiously products that will enable providers and governmental payers to make prudent use of grant funds and other incentives provided under both the Act and the HITECH Act. All stakeholders affected by the federal government's interrelated development of standards and protocols under HIPAA, the HITECH Act and the Act should closely monitor and, where possible, provide input on their development.


Bernadette M. Broccolo, Daniel Gottlieb and Jean Marie R. Pechette are partners in the law firm of McDermott Will & Emery LLP, and are based in the Firm's Chicago office.
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