[Federal Register Volume 70, Number 224 (Tuesday, November 22, 2005)]
[Proposed Rules]
[Pages 70574-70575]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-23077]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary

45 CFR Part 162

[CMS-0050-N]
RIN 0938-AK62


HIPAA Administrative Simplification: Standards for Electronic 
Health Care Claims Attachments; Extension of Comment Period

ACTION: Notice of extension of comment period for proposed rule.

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SUMMARY: This notice extends the comment period for a proposed rule 
published in the Federal Register on September 23, 2005 (70 FR 55990) 
that would recommend the adoption of a set of standards to facilitate 
the electronic exchange of clinical and administrative data to further 
improve the claims adjudication process when additional documentation 
is required. Due to the very technical nature of this rule, the 
industry is asking for additional time to conduct a more comprehensive 
and thorough review in order to provide comments to the Standards 
Development Organizations as well as to CMS. The comment period is 
extended for 60 days.

DATES: The comment period is extended to 5 p.m. on January 23, 2006.

ADDRESSES: In commenting, please refer to file code CMS-0050-P. Because 
of staff and resource limitations, we cannot accept comments by 
facsimile (FAX) transmission.
    You may submit comments in one of four ways (no duplicates, 
please):
    1. Electronically. You may submit electronic comments on specific 
issues in the September 23, 2005 proposed rule to http://www.cms.hhs.gov/regulations/ecomments. (Attachments should be in 
Microsoft Word, WordPerfect, or Excel; however, we prefer Microsoft 
Word.)
    2. By regular mail. You may mail written comments (one original and 
two copies) to the following address ONLY: Centers for Medicare & 
Medicaid Services, Department of Health and Human Services, Attention: 
CMS-0050-P, P.O. Box 8014, Baltimore, MD 21244-8014.
    Please allow sufficient time for mailed comments to be received 
before the close of the comment period.
    3. By express or overnight mail. You may send written comments (one 
original and two copies) to the following address ONLY: Centers for 
Medicare & Medicaid Services, Department of Health and Human Services, 
Attention: CMS-0050-P, Mail Stop C4-26-05, 7500 Security Boulevard, 
Baltimore, MD 21244-1850.
    4. By hand or courier. If you prefer, you may deliver (by hand or 
courier) your written comments (one original and two copies) before the 
close of the comment period to one of the following addresses. If you 
intend to deliver your comments to the Baltimore address, please call 
telephone number (410) 786-7195 in advance to schedule your arrival 
with one of our staff members. Room 445-G, Hubert H. Humphrey Building, 
200 Independence Avenue, SW., Washington, DC 20201; or, 7500 Security 
Boulevard, Baltimore, MD 21244-1850.
    (Because access to the interior of the HHH Building is not readily 
available to persons without Federal Government identification, 
commenters are encouraged to leave their comments in the CMS drop slots 
located in the main lobby of the building. A stamp-in clock is 
available for persons wishing to retain a proof of filing by stamping 
in and retaining an extra copy of the comments being filed.)
    Comments mailed to the addresses indicated as appropriate for hand 
or courier delivery may be delayed and received after the comment 
period.
    For information on viewing public comments, see the beginning of 
the SUPPLEMENTARY INFORMATION section.

FOR FURTHER INFORMATION CONTACT: Lorraine Doo, 410-786-6597.
    Submitting Comments: We welcome comments from the public on all 
issues set forth in the September 23, 2005 proposed rule to assist us 
in fully considering issues, developing policies and adopting 
standards. You can assist us by referencing the file code CMS-0050-P 
and the specific ``issue identifier'' that precedes the section on 
which you choose to comment.
    Inspection of Public Comments: All comments received before the 
close of the comment period are available for viewing by the public, 
including any personally identifiable or confidential business 
information that is included in a comment. CMS posts all comments 
received before the close of the comment period on its public Web site 
as soon as possible after they have been received. Comments received 
timely will be available for public inspection as they are received, 
generally beginning approximately 3 weeks after publication of a 
document, at the headquarters of the Centers for Medicare & Medicaid 
Services, 7500 Security Boulevard, Baltimore, Maryland 21244, Monday 
through Friday of each week from 8:30 a.m. to 4 p.m. To schedule an 
appointment to view public comments, phone 1-800-743-3951.

SUPPLEMENTARY INFORMATION: On September 23, 2005, we published a 
proposed rule in the Federal Register (70 FR 55990) that would 
recommend the adoption of a set of standards to facilitate the 
electronic exchange of clinical and administrative data to further 
improve the claims adjudication process when additional documentation 
is required. This rule proposes two X12N transaction standards: One to 
request the information, and one to respond to that request with the 
answer or additional information. This rule also proposes the use of 
Health Level 7 (HL7) specifications for the content and format of 
communicating the actual clinical information. Finally, this rule 
proposes the adoption of the Logical Observation Identifiers, Names and 
Codes or LOINC[supreg] for specific identification of the additional 
information being requested, and the coded answers that respond to the 
requests. Due to the highly technical nature of the materials, and the 
size (length) of the technical documents being reviewed, we want to 
provide additional time for the industry to review and comment upon all 
of the technical documents (implementation guides, specifications, code 
sets, modifiers), and the policies proposed in the September 23, 2005 
proposed rule.
    Due to the complexity of this proposed rule, the length of time

[[Page 70575]]

between the development of the proposed standards and the publication 
of this proposed rule, the potential need to upgrade the data content 
of the specifications or the use of Release 2 of the Clinical Document 
Architecture (CDA), numerous members of the industry and professional 
associations have requested more time to analyze the potential impact 
and consequences of the proposed rule. Thus, we have decided to extend 
the comment period for an additional 60 days. This document announces 
the extension of the public comment period to January 23, 2006.

    Authority: Secs. 1173 and 1175 of the Social Security Act (42 
U.S.C. 1302d-2 and 1320d-4).

    Dated: November 9, 2005.
Mark B. McClellan,
Administrator, Centers for Medicare & Medicaid Services.
    Dated: November 17, 2005.
Michael O. Leavitt,
Secretary.
[FR Doc. 05-23077 Filed 11-21-05; 8:45 am]
BILLING CODE 4120-01-P