HIPAA administrative simplification: enforcement. Final rule

The Secretary of Health and Human Services is adopting rules for the imposition of civil money penalties on entities that violate rules adopted by the Secretary to implement the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191 (HIPAA). The final rule amends the existing rules relating to the investigation of noncompliance to make them apply to all of the HIPAA Administrative Simplification rules, rather than exclusively to the privacy standards. It also amends the existing rules relating to the process for imposition of civil money penalties. Among other matters, the final rule clarifies and elaborates upon the investigation process, bases for liability, determination of the penalty amount, grounds for waiver, conduct of the hearing, and the appeal process.     

HIPAA administrative simplification: standards for electronic health care claims attachments. Proposed rule

This rule proposes standards for electronically requesting and supplying particular types of additional health care information in the form of an electronic attachment to support submitted health care claims data. It would implement some of the requirements of the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996.     

HIPAA administrative simplification: standard unique health identifier for health care providers. Final rule

This final rule establishes the standard for a unique health identifier for health care providers for use in the health care system and announces the adoption of the National Provider Identifier (NPI) as that standard. It also establishes the implementation specifications for obtaining and using the standard unique health identifier for health care providers. The implementation specifications set the requirements that must be met by "covered entities": Health plans, health care clearinghouses, and those health care providers who transmit any health information in electronic form in connection with a transaction for which the Secretary has adopted a standard (known as "covered health care providers"). Covered entities must use the identifier in connection with standard transactions. The use of the NPI will improve the Medicare and Medicaid programs, and other Federal health programs and private health programs, and the effectiveness and efficiency of the health care industry in general, by simplifying the administration of the health care system and enabling the efficient electronic transmission of certain health information. This final rule implements some of the requirements of the Administrative Simplification subtitle F of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).     

HIPAA administrative simplification: modification to medical data code set standards to adopt ICD-10-CM and ICD-10-PCS. Proposed rule

This proposed rule would modify two of the medical data code set standards adopted in the Transactions and Code Sets final rule published in the Federal Register. It would also implement certain provisions of the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Specifically, the proposed rule would modify the standard code sets for coding diagnoses and inpatient hospital procedures by concurrently adopting the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for diagnosis coding, and the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) for inpatient hospital procedure coding. These new codes would replace the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9- CM) Volumes 1 and 2, and the International Classification of Diseases, Ninth Revision, Clinical Modification (CM) Volume 3 for diagnosis and procedure codes, respectively.     

National Committee on Vital and Health Statistics: publication of recommendations relating to HIPAA health data standards--HHS. Notice

Section 1172 (f), Subtitle F of Pub. L. 104-191, the Health Insurance Portability and Accountability Act of 1996, requires the Secretary of Health and Human Services to publish in the Federal Register any recommendation of the National Committee on Vital and Health Statistics (NCVHS) regarding the adoption of a data standard under that law. On September 9, the NCVHS submitted recommendations to the Secretary relating to the unique identifier for payers, the unique identifier for individuals, and security standards. Accordingly, the full text of the NCVHS recommendations relating to HIPAA data standards is reproduced below. The text of the recommendations is also available on the NCVHS website: http@aspe.os.dhhs.gov/ncvhs/.     

National Practitioner Data Bank; announcement of opening date--PHS. Notice of opening

The Health Resources and Services Administration, Public Health Service, Department of Health and Human Services (DHSS), is announcing the opening date of the National Practitioner Data Bank (Data Bank), as authorized by the Health Care Quality Improvement Act of 1986 (the Act), title IV of Public Law 99-660 as amended (42 U.S.C. 11101 et seq.).     

HIPAA Newborns' and Mothers' Health Protection Act--IRS. Notice of proposed rulemaking by cross-reference to temporary regulations

Elsewhere in this issue of the Federal Register, the IRS is issuing temporary regulations relating to minimum hospital length-of-stay requirements imposed on group health plans with respect to mothers and newborns. The hospital length-of-stay requirements were added to the Internal Revenue Code by section 1531 of the Taxpayer Relief Act of 1997. The IRS is issuing the temporary regulations at the same time that the Pension and Welfare Benefits Administration of the U.S. Department of Labor and the Health Care Financing Administration of the U.S. Department of Health and Human Services are issuing substantially similar interim final regulations relating to hospital length-of-stay requirements added by the Newborns' and Mothers' Health Protection Act of 1996 to the Employee Retirement Income Security Act of 1974 and the Public Health Service Act. The temporary regulations provide guidance to employers and group health plans relating to the new hospital length-of-stay requirements. The text of those temporary regulations also serves as the text of these proposed regulations.     

National Medical Support Notice. Pension and Welfare Benefits Administration, Labor. Final rule

This document contains a final rule that promulgates a National Medical Support Notice to be issued by State agencies as a means of enforcing the health care coverage provisions in a child support order, and to be treated by plan administrators of group health plans as a qualified medical child support order under section 609(a) of Title I of the Employee Retirement Income Security Act (ERISA). Through this regulation, the Department of Labor (the Department) is implementing an amendment to section 609(a) of ERISA, made by section 401 of the Child Support Performance and Incentive Act of 1998 (CSPIA), Pub. L. 105-200. This rule will affect group health plans, participants in group health plans, noncustodial children of such participants, and State agencies that administer child support enforcement programs.     

National guidelines for health planning: Public Health Service, HHS. Notice of proposed rulemaking

This Notice proposes to add national health planning goals to the National Guidelines for Health Planning under section 1501 of the Public Health Service Act. These goals concern health status outcomes, disease prevention and health promotion and personnel resources and systems of care. They supplement Subparts A and C of the Guidelines published as final regulations on March 28, 1978, which addressed standards for nine types of health services and facilities. Later issuances will provide additional goals and standards.     

书写、传播成本与作者的独立身份——著作权制度产生之前作品传播略考

通过考察各主要文明的发展历程发现,书写、传播成本在相当程度上决定了作者的身份是否独立,而身份独立则是思想自由的前提.一种文明要想长存,必须降低书写、传播成本,赋予作者独立的身份,使之能够凭借自己的创作而收获财富.著作权制度就是以法律的形式保障了这种独立身份.     

National Medical Support Notice. Office of Child Support Enforcement, Administration for Children and Families, HHS. Final rule

This rule implements provisions of the Child Support Performance and Incentives Act of 1998 (CSPIA), Public Law 105-200, that require State child support enforcement agencies, under title IV-D of the Social Security Act (the Act), to enforce the health care coverage provision in a child support order through the use of the National Medical Support Notice (NMSN). A proposed rule was published in the Federal Register on November 15, 1999 (64 FR 62074). After consideration of the written comments received, changes have been made in this final regulation, including changes to the NMSN found in the Appendix.     

Crime Clearance and Temporal Variation in Police Investigative Workload: Evidence from National Incident-Based Reporting System (NIBRS) Data

Objectives

Police workload’s relationship with crime clearance has been studied widely. In the challenging environment now facing police, even small and possibly temporary changes in investigative workload could harm clearance. However existing workload-clearance research either used only a yearly average that obscures temporal variability in caseload, or explored proxy rather than direct measures of workload’s short-term variation. Our improved workload measures capture caseload’s daily changes as crimes are reported, cleared, or remain uncleared but reach the end of active investigation. We examine relationships between clearance and both long- and short-term variability in workload.

Methods

Using NIBRS and LEMAS data, we calculated between-agency (typical or long-term) and time-varying, within-agency (daily fluctuating or short-term) workload measures. We used these and other agency/jurisdiction- and incident-level variables in multi-level survival analysis of clearance by arrest for serious violent incidents from 2007 NIBRS.

Results

Both workload measures were significantly and negatively related to the clearance hazard rate; higher long- and short-term workloads are associated with reduced chance of a case being cleared. The estimated relationship between longterm workload and clearance became progressively stronger (more negative) as the crime incident’s legal seriousness decreased. However, estimates indicated greater sensitivity of the clearance hazard to short-term workload fluctuations for more serious crimes, though the workload-clearance relationship remained negative for all crime types.

Conclusion

Crime clearance should be considered by police agency planners when addressing workload through staffing decisions. Refinement of our workload measures will require additional information, and should be considered in future agency- and incident-level data collection.

     

Health maintenance organizations; reestablishment of compliance by Kaiser Foundation Health Plan, Inc.: Public Health Service. Notice, continued regulation of health maintenance organizations

On December 4, 1981, the Office of Health Maintenance Organizations (OHMO) notified Kaiser Foundation Health Plan, Inc. that Kaiser-Georgetown Community Health Plan, Inc.), (formerly Georgetown University Community Health Plan, Inc.), 4200 Wisconsin Avenue, NW., Suite 300, Washington, D.C., a federally qualified health maintenance organization (HMO), had successfully reestablished compliance with its assurance to the Secretary that it would maintain a fiscally sound operation. This determination took effect on December 1, 1981.     

The National Incident-Based Reporting System: Research and Policy Applications

The National Incident-Based Reporting System (NIBRS) offers a new source ofdata for measuring crime. Though far from national in coverage, NIBRS datacan address research and policy questions outside the scope of the UniformCrime Reports and the National Crime Victimization Survey. Comparisons ofthe three sources of crime data are presented, with particular emphasis onwhat can be learned from incident-based police data that cannot be learnedfrom other sources. Like all data on crime, the NIBRS is subject to variousproblems with validity and measurement error. Two general categories of suchproblems are discussed: those evident in the design of the NIBRS and thoselinked to more general issues in the organizational production of data.     

Administrative simplification: adoption of a standard for a unique health plan identifier; addition to the National Provider Identifier requirements; and a change to the compliance date for the International Classification of Diseases, 10th Edition (ICD-10-CM and ICD-10-PCS) medical data code sets. Final rule

This final rule adopts the standard for a national unique health plan identifier (HPID) and establishes requirements for the implementation of the HPID. In addition, it adopts a data element that will serve as an other entity identifier (OEID), or an identifier for entities that are not health plans, health care providers, or individuals, but that need to be identified in standard transactions. This final rule also specifies the circumstances under which an organization covered health care provider must require certain noncovered individual health care providers who are prescribers to obtain and disclose a National Provider Identifier (NPI). Lastly, this final rule changes the compliance date for the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) for diagnosis coding, including the Official ICD-10-CM Guidelines for Coding and Reporting, and the International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS) for inpatient hospital procedure coding, including the Official ICD-10-PCS Guidelines for Coding and Reporting, from October 1, 2013 to October 1, 2014.     

Health Care Financing Administration: adoption of the National Bureau of Standards fire safety evaluation system for health care facilities. Notice of comment period

The Department of Health, Education, and Welfare is proposing to extend use of the new Fire Safety Evaluation System (FSES) to all hospitals participating in the Medicare and Medicaid programs. We are seeking public comment on this proposal and on whether to apply the FSES to intermediate care and skilled nursing facilities. The Fire Safety Evaluation System (FSES) was designed by the National Bureau of Standards. It defines the combinations of widely accepted fire safety systems and structural arrangements which can be used by health care facilities to meet safety standards equal to or exceeding those in the Life Safety Code. The FSES provides a framework which guarantees that the high standards of fire safety necessary to protect patients will be met and which is flexible enough to allow for new advances in safety technology and practice. It is based on our experience, which clearly demonstrates that the Life Safety Code can be implemented more effectively and without waste if certain changes are made in the procedures for achieving these mandated levels of safety.     

National Practitioner Data Bank; change in user fee and elimination of diskette queries--HRSA. Withdrawal

National Practitioner Data Bank; Change in User Fee and Elimination of Diskette Queries notice, document 98-2637, pages 5811-5812, Volume 63, Number 23, in the issue of Wednesday, February 4, 1998, was published in error and is withdrawn from publication. The correct version of the notice was published on Thursday, January 29, 1998, Document No. 98-2116, Volume 63, Number 19, page 4460.     

Heckler v. Chaney: judicial and administrative regulation of capital punishment by lethal injection

Capital punishment by lethal injection, which was expected to be the most safe and effective of available methods, can produce unusually cruel and inhuman death. In Heckler v. Chaney, inmates sentenced to death by lethal injection, as well as members of both the medical and legal communities, challenged the Food and Drug Administration's (FDA) refusal to regulate certain drugs used for capital punishment by lethal injection. By declining to review the FDA's nonenforcement decision, the Supreme Court also declined an opportunity to reevaluate its standard for determining cruel and unusual punishment, which upholds any method of execution that is no more unusually cruel than existing methods. This Comment examines the propriety of judicial and administrative regulation of capital punishment by lethal injection.     

Medicare and Medicaid programs; Medicare-Medicaid coverage data bank requirements: preliminary guidance--HCFA. Notice

This notice informs the public about section 1144 of the Social Security Act, which is self-implementing, and provides preliminary guidance to employers who are required to report information about all individuals covered by group health plans to a newly established Medicare-Medicaid Coverage Data Bank. Information in the data bank will be used to help identify situations where employer group health plans are responsible for making primary payments for services received by Medicare or Medicaid beneficiaries. This notice provides: information on the background and legislative authority for the data bank; definitions of key terms; reporting requirements; the identity of entities that are required to, or may, report; reporting dates; penalties for noncompliance; and methods of reporting.