FROM: DONALD BRYAN, ACTING COMMISSIONER
RE: HEALTH INFORMATION ELECTRONIC DATA INTERCHANGE TECHNOLOGY ACT (commonly referred to as "HINT") P.L. 1999, c. 154 and N.J.A.C. 11:22-3The purpose of this Bulletin is to address the impact of recent changes in the compliance dates of the Federal HIPAA Administrative Simplification Rules on the implementation of HINT and N.J.A.C. 11:22-3. Legislation was signed by President Bush on December 27, 2001 that permits payers to seek an extension of the required deadline for use of HIPAA’s electronic transaction and code sets. Payers will be required to use the new electronic formats on October 16, 2002 (the original date set for compliance) by the federal government unless they submit a plan and request for additional time to the Secretary of Health and Human Services ("HHS").
The request to HHS for additional time must include the following:
Any entity failing to file such a plan by October 16, 2002, will be required to adhere to the original deadline established by HHS.
The Department notes that the scope of the HINT law and rules is different from that of HIPAA; HINT only addresses the implementation of electronic claims and enrollment forms in accordance with a schedule developed by this Department. The HIPAA rules establish eight separate transaction and code sets to cover all health care transactions. The HINT law and rules require health care providers to file all patient claims as of October 1, 2002 unless the patient elects to file the claim directly with the payer, and encourages the electronic filing of claims by providers. The HIPAA rules do not address these issues.
The HINT law does not require contemporaneous implementation with HIPAA. The obligations imposed by HINT are separate and distinct from those that are imposed by HIPAA. Nonetheless, a coordinated approach is necessary, since the HIPAA transaction sets will form the basis for HINT implementation.
In response to changes in the HIPAA implementation deadline and the absence of certain coding and transaction sets, some payers have asked the Department to reconsider its schedule for the early implementation of electronic claims and enrollment forms and the requirements of HINT. They also ask that all separate reporting requirements to this Department be eliminated to eliminate any redundancy with the HHS reporting requirements.
The HINT law and rules provide a mechanism for addressing the current situation. Pursuant to N.J.A.C. 11:22-3.5, payers may apply to the Department for an extension of time for compliance with the deadlines established in 11:22-3.6 and 3.7. The Commissioner will grant an extension of the HINT compliance deadlines for those payers who submit to the Department by October 1, 2002 a certification by a responsible officer that the company submitted a proper request to HHS for an extension of time for compliance with the HIPAA requirements, and that the company is participating in statewide strategic implementation of the electronic claims and enrollment forms testing.
1/3/2002 /s/ Donald Bryan, Acting Commissioner