WEDI Newsletter  |  May 2017
Executive Corner | Cybersecurity Resources | WEDI Presents Testimony to NCVHS Subcommittee on HPID | Join us for the WEDI 2017 Summer Forum |
Workgroup Roundup | Latest Member News
Conference Recap and a Look Forward

WEDI 2017 in Hollywood is now over and attendees brought back to their organizations a wealth of both practical information and forward-thinking perspectives. This year’s conference presented the opportunity for participants to hear directly from policymakers, innovative thinkers in the healthcare environment, and those on the ground floor of implementation efforts. Here are a few of the highlights.

Powerful and inspirational keynotes from former Kaiser Permanente CEO George Halvorson, DHX Group founder David Vinson, and Darren Dworkin, SVP/CIO at Cedars-Sinai Health System, helped set the stage for each day’s deep dives into critical issues impacting WEDI members.

The conference also afforded the opportunity to hear directly from federal policymakers with Monday’s Privacy & Cybersecurity Forum kicked off by HHS Deputy Chief Information Officer and Senior Cybersecurity Advisor Leo Scanlon. Scanlon shared his perspectives remotely on the growing cybersecurity threat facing healthcare as he was directly in the middle of managing the Department’s response to the “WannaCry” cyberattack. FBI Special Agent Bryan Willett offered his agency’s perspective on today’s and tomorrow’s “cyber threatscape,” and, courtesy of Dr. Monica Kay from CMS, attendees heard the latest on the agency’s Social Security Number Removal Initiative. 

WEDI chair-elect Jay Eisenstock had the distinct honor of presenting Jim Daley, a long-time WEDI board member, past chair, workgroup co-chair, industry leader, and wonderful colleague with a special award in recognition of his distinguished service to the organization.

The three breakout tracks, the Business of Health IT, Data Exchange, and Healthcare Consumerism, featured expert speakers and timely topics. Sessions covered a wide variety of topics that included a preview of the Trump Administration and its potential impact on Health IT, multiple discussions on electronic attachments, and even a conversation on how the industry can reduce eligibility phone calls.

Panel general sessions often are WEDI conference favorites, and this year’s slate were no exception. Attendees were treated to a spirited discussion of the importance and impact of accreditation and certification on healthcare entities with EHNAC’s Lee Barrett, Bob Bowman from CAQH CORE, and HITRUST’s Michael Frederick. Not surprising, the issue of Prior Authorization was front and center at the conference, and two excellent panels showcased the tremendous work of the WEDI volunteers. The three co-chairs of the WEDI Prior Authorization Subworkgroup, Janice Bakos, Brad Hughes, and Heather McComas, outlined numerous challenges facing both providers and payers and led the audience through a discussion of industry best practices identified by the workgroup. At another session, Charles Stellar, WEDI President and CEO, and Jay Eisenstock discussed the role of the new Prior Authorization Council with its chair, John Kelly. You will hear more in the future about this important new WEDI initiative.

The conference’s final day served to emphasize the important work of the many WEDI workgroups and subworkgroups. Taking advantage of having members at the venue were the Innovative Encounters and Payment Models Workgroups and the Prior Authorization, Attachments, and Remittance Advice and Payments Subworkgroups.

As with every WEDI event, attendees took full advantage of the vendor exhibitions and the many unique and effective networking opportunities afforded during the 4-day conference. Business deals were struck, partnerships forged, and friendships made and renewed. For those who were not able to make it out to California for WEDI 2017, you will not want to miss the August Summer Forum in Chicago or the December National Conference in Reston, Virginia. Learn more about these events at WEDI.org.

Robert Tennant, WEDI vice-chair, marketing and communications
Following the WannaCry cyberattacks from the other week, we shared some resources and information that we felt our members would find helpful as they further evaluate action points for preventing and handling this and other potential cyberattacks of this nature. One of which was our recent “ The Rampant Growth of Cybercrime in Healthcare” white paper .

Additionally, HHS and ONC are doing an exceptional job in providing links and information on a regular basis. We’d recommend you to sign up on HHS.gov or ONC.gov to receive all future announcements directly as well.

OCR’s listserv is a key resource for HIPAA covered entities and their business associates to obtain the latest information not only on this recent cyber incident, but also with best practices on how to prepare for and respond to ransomware attacks. OCR also has a number of monthly cyber newsletters that have addressed this topic, as well as Guidance.  These resources may be found at:

Cyber Newsletters: 

OCR’s Ransomware Guidance

On May 4, 2017, WEDI presented before the Department of Health and Human Services, National Committee on Vital and Health Statistics (NCVHS), Subcommittee on Standards. Laurie Darst, Chair of the WEDI Board of Directors, presented testimony concerning the future of the Unique Health Plan Identifier (HPID) under the Administrative Simplification provisions of the Affordable Care Act (ACA).

According to WEDI’s testimony: “In July 2015, the Centers for Medicare & Medicaid Services (CMS) issued a ‘Request for Information (RFI) on the Requirements for the HPID.’ At that time, WEDI held a Technical Advisory Committee (TAC) to provide a forum for healthcare organizations to convene, discussing in detail issues relating to regulatory provisions for the HPID. The outcome of the discussion was a set of comments that were reviewed and approved by the 2015 WEDI Board of Directors’ Executive Committee. WEDI found after holding many discussions with its members upon publication of the Final Rule in 2012 that perceptions of what HPID would provide the industry versus the realities of how health plans intended to enumerate had changed. We have not heard any new feedback from WEDI members which would modify our comments to HHS/CMS in response to the RFI in July 2015.”

WEDI’s testimony also addressed several questions put forth from the Subcommittee including those pertaining to the benefits and challenges seen with the current HPID model established by HHS.

“WEDI members have not identified any benefits to the HPID model as established by the final regulation. Implementation of the provisions within the HPID regulation would create challenges and barriers to the workflows and transaction streams currently in use,” said Darst. “Our recommendations remain the same today as they did back in July 2015, that being HPID not be used in transactions and that HPID is not needed at all. WEDI supports the continued efforts of all stakeholders towards achieving administrative simplification within healthcare and supports focusing collaboration and communication among industry participants on topics that bring value to the industry.”

WEDI has previously provided testimony on Operating Rules in 2010, 2011, 2015 and 2016 and will continue to monitor and update HHS on any pertinent industry regulatory changes in the future. 

WEDI’s complete May 4 testimony can be found here.

Make your summer plans now to join us for the WEDI Summer Forum on August 1-2, 2017 in Chicago, Illinois where attendees will deep dive into solutions to prior authorization and health IT policy issues.


Registration is available now on the WEDI website. Stay tuned for the agenda and additional details.

All of our workgroups have great projects and things underway, here’s just a brief highlight of a few things to stay tuned for:

  • The Prior Authorization Subworkgroup has created the Prior Authorization Challenges and Best Practices white paper, which is currently in the approval process. This document will outline industry challenges related to prior authorization workflows, transaction implementation, and process automation and offer best practices suggested by the subworkgroup. The document will also provide sample workflows that illustrate how the concepts outlined in the best practices could be implemented.
  • The Claims Subworkgroup just completed reviewing the X12 Version 7030 claim transactions for the public comment period and provided comments to WEDI leadership to be submitted to X12. During the review, the subworkgroup identified several topics for further education. The subworkgroup also welcomed aboard Chris Muschong from Kunz, Leigh and Associates as a co-chair. He brings 20 years of experience developing and supporting customized software solutions, currently for the Michigan Department of Health and Human Services. 
  • The Remittance Advice & Payment Subworkgroup has created the Barriers to Adoption of the ERA and EFT Transactions white paper, which is currently in the approval process. The purpose of this paper is to identify barriers to adoption of the HIPAA-standard ERA and EFT transactions (835 and CCD+), to discuss in detail the reason behind these barriers, and to suggest steps that providers, payers, trading partners and vendors can take to eliminate the barriers and implement the transactions.

And in case you missed it:

  • The Innovative Encounters Workgroup published the Introduction to Telehealth Codes back in December. This issue brief provides introductory information on codes for telehealth services, development of codes for telehealth services, and challenges with telehealth coding.
  • The Payment Models Workgroup published Electronic Payments: Guiding Principles in August 2016. Despite having a national standard and supporting operating rules, ACH EFT is significantly underutilized by the industry, with the most recent CAQH Index® reporting that only 61.4% of claims payment are made via ACH EFT. The purpose of this principles document is to establish a consensus-driven set of principles that each impacted stakeholder could review and adopt in an effort to drive adoption of ACH EFT, while at the same time establishing guidelines for the use of alternative payment options. 
  • The Genomics Workgroup published Maximizing the Potential of Genomic Information to Improve Care Coordination and Health Outcomes in August 2016. This white paper explores how genomic information could optimize clinical genomics care coordination, including how genomic data can be leveraged to improve health and care at both individual and population levels. It examines a number of clinical situations and life stages during which genomic information is generated, how health care providers access and use that data, the infrastructure needed for effective use of the data and the financial drivers of genomic data use for improved health care.

Health Plans/Insurers

Not-for-Profits

Technology Solutions/Vendors

Providers

If you are a WEDI Corporate Member organization and would like to have your press releases included in a future edition of the WEDI Monthly Newsletter, please email with a link to your press release to jennifer@andersoni.com

The Workgroup for Electronic Data Interchange (WEDI) is the leading authority on the use of health IT to improve healthcare information exchange in order to enhance the quality of care, improve efficiency and to reduce costs of the American healthcare system. Formed in 1991 by the Secretary of Health and Human Services (HHS), WEDI was named in the 1996 HIPAA legislation as an advisor to HHS and continues to fulfill that role today.
WEDI | (202) 618-8788 | wedi@wedi.org | wedi.org