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GAO-11-838R 1 (2011-07-21)

handle is hein.gao/gaobadxey0001 and id is 1 raw text is: J GAO Accountability * Integrity * Reliability United States Government Accountability Office Washington, DC 20548 B-322209 July 21, 2011 The Honorable Tom Harkin Chairman The Honorable Michael B. Enzi Ranking Member Committee on Health, Education, Labor, and Pensions United States Senate The Honorable Fred Upton Chairman The Honorable Henry A. Waxman Ranking Member Committee on Energy and Commerce House of Representatives Subject: Department of Health and Human Services, Office of the Secretary: Administrative Simplification: Adoption of Operating Rules for Eligibility for a Health Plan and Health Care Claim Status Transactions Pursuant to section 801 (a)(2)(A) of title 5, United States Code, this is our report on a major rule promulgated by the Department of Health and Human Services (HHS), Office of the Secretary, entitled Administrative Simplification: Adoption of Operating Rules for Eligibility for a Health Plan and Health Care Claim Status Transactions (RIN: 0938-AQ12). We received the rule on June 30, 2011. It was published in the Federal Register as an interim final rule with comment period on July 8, 2011. 76 Fed. Reg. 40,458. Section 11 04(b)(2) of the Patient Protection and Affordable Care Act requires HHS to establish operating rules for each Health Insurance Portability and Accountability Act of 1996 (HIPAA) transaction.1 This interim final rule with comment period adopts operating rules for two HIPAA transactions: eligibility for a health plan and health care claim status. This rule also defines the term operating rules and explains the role of operating rules in relation to the adopted transaction standards. In general, transaction standards adopted under HIPAA enable electronic data interchange 1 Pub. L. No. 111-148, § 1104(b)(2), 124 Stat. 119, 147 (Mar. 23, 2010). GAO-1 1-838R

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