§1320d–1 General Requirements for Adoption of Standards

Summary

Standards created under this law must apply to three groups: a health plan, a health care clearinghouse, and any health care provider who sends health information electronically for the transactions in section 1320d–2(a)(1). The standards must aim to cut the paperwork and other administrative costs of giving and paying for health care. Normally the standards must come from a standard‑setting organization. The Secretary may pick a different standard only if it will substantially cut costs and is made using the rulemaking procedures of subchapter III of chapter 5 of title 5. If no standard‑setting group has made a needed standard, paragraph (1) does not apply and subsection (f) applies. Standards must be developed after consulting the National Uniform Billing Committee, the National Uniform Claim Committee, the Workgroup for Electronic Data Interchange, and the American Dental Association. The Secretary must set implementation details, must not force disclosure of trade secrets or confidential commercial information except as law requires, must rely on recommendations from the National Committee on Vital and Health Statistics and consult federal and state agencies and private groups, and must publish that Committee’s recommendations in the Federal Register. Changes to standards are treated the same as new standards.