Most Health Care Providers Unprepared for HIPAA Electronic Transaction Standards Compliance

Eighty-five percent of health care providers have not completed "assessments or gap analyses" of the requirements necessary to comply with electronic transaction standards mandated by the 1996 Health Insurance Portability and Accountability Act, according to a study conducted by Gartner Inc. In addition, the study found that 68% of providers are "uncertai[n] about ultimate deadlines for compliance" and have "doubts on whether HIPAA ... is here to stay." Matt Duncan, Gartner's research director and the study's author, said, "These doubts, driven by continuing lobbying efforts and bills in Congress to effectively kill the regulation with a two- to four-year deadline extension, are severely damaging the HIPAA transaction regulation compliance effort." Other survey findings include:

54% of providers have either not asked or not received responses from their software vendors on HIPAA compliance strategies.
84% of providers and payers "expect" their software vendors to "supply compliance" under terms of their maintenance contracts.
55% of health care organizations believe a one-year extension for compliance would "improve chance[s]" of meeting the law's objectives.

Based on the findings, Gartner recommends pushing the deadline for compliance with HIPAA back one year, to Oct. 16, 2003, so that providers and health insurers have "enough time" to update their computer systems for electronic claims filing and processing. In addition to extending the compliance deadline, Gartner is pushing for a "six-month transition period" before all providers are required to submit claims electronically. Further, Gartner is "strongly recommed[ing]" that Congress quickly resolve any pending legislation regarding HIPAA and that HHS "expedite publication of the final enforcement rule." Duncan said, "The health care industry will not suddenly become standardized in the next 15 months. The government and the health care industry have an obligation to plan this transaction responsibly" (Gartner release, 7/18).
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