[Federal Register: August 17, 2000 (Volume 65, Number 160)]

[Notices]               

[Page 50373]

From the Federal Register Online via GPO Access [wais.access.gpo.gov]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES


Health Care Financing Administration


[HCFA-0149-N]

RIN 0938-AI58
 

Health Insurance Reform: Announcement of Designated Standard 

Maintenance Organizations


AGENCY: Office of the Secretary, HHS.


ACTION: Notice.


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SUMMARY: This notice announces the organizations that the Secretary 

designates as Designated Standard Maintenance Organizations (DSMOs). 

These organizations maintain standards for health care transactions 

adopted by the Secretary, and receive and process requests for adopting 

a new standard or modifying an adopted standard. This notice is 

published in accordance with our final rule titled Standards for 

Electronic Transactions, published elsewhere in this Federal Register, 

which implements section 262 of the Health Insurance Portability and 

Accountability Act, which added sections 1171 through 1179 to the 

Social Security Act.


EFFECTIVE DATE: October 16, 2000.


FOR FURTHER INFORMATION CONTACT: Stanley Nachimson, (410) 786-6153.


SUPPLEMENTARY INFORMATION:


Background


    Section 262 of the Health Insurance Portability and Accountability 

Act (HIPAA) added sections 1171 through 1179 to the Social Security Act 

(the ``Act''). Section 1173(a) of the Act requires the Secretary to 

adopt standards for health care transactions to enable electronic 

exchange of health information. In addition, section 1172 of the Act 

requires consultation prior to the adoption of a standard with the 

following Data Content Committees (DCCs): National Uniform Billing 

Committee (NUBC), the National Uniform Claim Committee (NUCC), the 

Workgroup for Electronic Data Interchange (WEDI), and the American 

Dental Association prior to the adoption of a standard. In the case of 

a standard that has been developed, adopted, or modified by a standard 

setting organization (SSO), the SSO is to consult with the above-named 

groups during such development, adoption, or modification. In the case 

of any other standard, the Secretary is required to consult with each 

of the above-named groups before adopting the standard and must also 

comply with the provisions of section 1172(f) of the Act regarding 

consultation with the National Committee on Vital and Health 

Statistics.

    The final rule titled ``Standards for Electronic Transactions,'' 

published elsewhere in this Federal Register, establishes a new 

category of organization, the ``Designated Standard Maintenance 

Organization (DSMO).'' Section 162.910 of this final regulation 

provides that the Secretary may designate as DSMOs those organizations 

that agree to maintain the standards adopted by the Secretary. Section 

162.910 also establishes criteria for the processes to be used in such 

maintenance. Several DCCs and SSOs have agreed to maintain those 

standards designated as national standards in the final rule 

``Standards for Electronic Transactions'' according to the criteria 

established by the Secretary.


Provisions of the Notice


    Pursuant to Sec. 162.910, the Secretary designates the following 

organizations as DSMOs:

    1. Accredited Standards Committee X12.

    2. Dental Content Committee of the American Dental Association.

    3. Health Level Seven.

    4. National Council for Prescription Drug Programs.

    5. National Uniform Billing Committee.

    6. National Uniform Claim Committee.


    Authority: Section 1172 of the Social Security Act (42 U.S.C. 

1320d-1)


(Catalog of Federal Domestic Assistance Program No. 93.778, Medical 

Assistance Program; No. 93.773 Medicare--Hospital Insurance Program; 

and No. 93.774, Medicare--Supplementary Medical Insurance Program)


    Dated: July 24, 2000.

Donna Shalala,

Secretary.

[FR Doc. 00-20821 Filed 8-11-00; 3:41 pm]

BILLING CODE 4120-01-P