Still struggling to submit standard transactions in compliance with the Health Insurance Portability and Accountability Act (HIPAA), the healthcare industry is "not even close" to standardizing healthcare business transactions and realizing the promise of a return on investment, according to the results of the Summer 2004 edition of the U.S. Healthcare Industry HIPAA Survey. Conducted from June 1-15, 2004, by Phoenix Health Systems and the Healthcare Information and Management Systems Society (HIMSS), the survey results are based on the responses of 540 healthcare industry representatives. As of 2004, the survey is conducted semi-annually, instead of quarterly as in prior years, with the next survey scheduled for January 2005.

"The crux of HIPAA transactions compliance and genuine "administrative simplification" is readiness by all parties. These most recent findings indicate that many providers and payers may be ready to produce compliant transactions, but their trading partners cannot accept or transmit them," said D'Arcy Guerin Gue, executive vice president of Phoenix Health Systems. "The questions that continue to stump the healthcare industry are how will it join together, as it must, to achieve across-the-board readiness, and when will it do so?"
Key findings of the Summer 2004 Survey include:

  • HIPAA Transaction and Code Set Testing: With almost two-thirds of respondents reporting complete TCS compliance, less than half of providers and payers are now conducting all the standard transactions required for their business functions. Of the non-compliant covered entities, or providers, payers and clearinghouses, 68 percent have completed internal testing but only 27 percent have completed external testing.
  • HIPAA Privacy: The deadline for the HIPAA Privacy Rule was April 2003 and despite the risk of complaints and federal penalties, 22 percent of providers and nine percent of payers still reported that they remain non-compliant with the Privacy Rule. Even compliant organizations cited gaps in key areas, including establishing business associate agreements and monitoring internal privacy compliance.
  • HIPAA Security: Looking ahead to April 21, 2005, the deadline for HIPAA Security compliance, 87 percent of providers, 91 percent of payers and 90 percent of clearinghouses reported that their organizations will not be compliant until that date. Thirty-one percent of total providers, payers and clearinghouses also said that their organizations had experienced at least one data security breach in the last six months, from January - June 2004.

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