Confess

SEC. 163. ADMINISTRATIVE SIMPLIFICATION. (a) Standardizing Electronic Administrative Transactions- (1) IN GENERAL- Part C of title XI of the Social Security Act (42 U.S.C. 1320d et seq.) is amended by inserting after section 1173 the following new section: ‘SEC. 1173A. STANDARDIZE ELECTRONIC ADMINISTRATIVE TRANSACTIONS. ‘(a) Standards for Financial and Administrative Transactions- ‘(1) IN GENERAL- The Secretary shall adopt and regularly update standards consistent with the goals described in paragraph (2). ‘(2) GOALS FOR FINANCIAL AND ADMINISTRATIVE TRANSACTIONS- The goals for standards under paragraph (1) are that such standards shall-- ‘(A) be unique with no conflicting or redundant standards; ‘(B) be authoritative, permitting no additions or constraints for electronic transactions, including companion guides; ‘© be comprehensive, efficient and robust, requiring minimal augmentation by paper transactions or clarification by further communications; 13 ‘(D) enable the real-time (or near real-time) determination of an individual’s financial responsibility at the point of service and, to the extent possible, prior to service, including whether the individual is eligible for a specific service with a specific physician at a specific facility, which may include utilization of a machine-readable health plan beneficiary identification card; ‘(E) enable, where feasible, near real-time adjudication of claims; ‘(F) provide for timely acknowledgment, response, and status reporting applicable to any electronic transaction deemed appropriate by the Secretary; ‘(G) describe all data elements (such as reason and remark codes) in unambiguous terms, not permit optional fields, require that data elements be either required or conditioned upon set values in other fields, and prohibit additional conditions; and ‘(H) harmonize all common data elements across administrative and clinical transaction standards. ‘(3) TIME FOR ADOPTION- Not later than 2 years after the date of implementation of the X12 Version 5010 transaction standards implemented under this part, the Secretary shall adopt standards under this section. ‘(4) REQUIREMENTS FOR SPECIFIC STANDARDS- The standards under this section shall be developed, adopted and enforced so as to-- ‘(A) clarify, refine, complete, and expand, as needed, the standards required under section 1173; ‘(B) require paper versions of standardized transactions to comply with the same standards as to data content such that a fully compliant, equivalent electronic transaction can be populated from the data from a paper version; 4 ‘© enable electronic funds transfers, in order to allow automated reconciliation with the related health care payment and remittance advice; ‘(D) require timely and transparent claim and denial management processes, including tracking, adjudication, and appeal processing; 1 ‘(E) require the use of a standard electronic transaction with which health care providers may quickly and efficiently enroll with a health plan to conduct the other electronic transactions provided for in this part; and ‘(F) provide for other requirements relating to administrative simplification as identified by the Secretary, in consultation with stakeholders. ‘(5) BUILDING ON EXISTING STANDARDS- In developing the standards under this section, the Secretary shall build upon existing and planned standards. ‘(6) IMPLEMENTATION AND ENFORCEMENT- Not later than 6 months after the date of the enactment of this section, the Secretary shall submit to the appropriate committees of Congress a plan for the implementation and enforcement, by not later than 5 years after such date of enactment, of the standards under this section. Such plan shall include-- ‘(A) a process and timeframe with milestones for developing the complete set of standards; ‘(B) an expedited upgrade program for continually developing and approving additions and modifications to the standards as often as annually to improve their quality and extend their functionality to meet evolving requirements in health care; ‘© programs to provide incentives for, and ease the burden of, implementation for certain health care providers, with special consideration given to such providers serving rural or underserved areas and ensure coordination with standards, implementation specifications, and certification criteria being adopted under the HITECH Act; ‘(D) programs to provide incentives for, and ease the burden of, health care providers who volunteer to participate in the process of setting standards for electronic transactions; ‘(E) an estimate of total funds needed to ensure timely completion of the implementation plan; and ‘(F) an enforcement process that includes timely investigation of complaints, random audits to ensure compliance, civil monetary and programmatic penalties for non-compliance consistent with existing laws and regulations, and a fair and reasonable appeals process building off of enforcement provisions under this part. ‘(b) Limitations on Use of Data- Nothing in this section shall be construed to permit the use of information collected under this section in a manner that would adversely affect any individual. ‘© Protection of Data- The Secretary shall ensure (through the promulgation of regulations or otherwise) that all data collected pursuant to subsection (a) are-- ‘(1) used and disclosed in a manner that meets the HIPAA privacy and security law (as defined in section 3009(a)(2) of the Public Health Service Act), including any privacy or security standard adopted under section 3004 of such Act; and ‘(2) protected from all inappropriate internal use by any entity that collects, stores, or receives the data, including use of such data in determinations of eligibility (or continued eligibility) in health plans, and from other inappropriate uses, as defined by the Secretary.’. (2) DEFINITIONS- Section 1171 of such Act (42 U.S.C. 1320d) is amended-- (A) in paragraph (7), by striking ‘with reference to’ and all that follows and inserting ‘with reference to a transaction or data element of health information in section 1173 means implementation specifications, certification criteria, operating rules, messaging formats, codes, and code sets adopted or established by the Secretary for the electronic exchange and use of information’; and (B) by adding at the end the following new paragraph: ‘(9) OPERATING RULES- The term ‘operating rules’ means business rules for using and processing transactions. Operating rules should address the following: ‘(A) Requirements for data content using available and established national standards. ‘(B) Infrastructure requirements that establish best practices for streamlining data flow to yield timely execution of transactions. ‘© Policies defining the transaction related rights and responsibilities for entities that are transmitting or receiving data.’. (3) CONFORMING AMENDMENT- Section 1179(a) of such Act (42 U.S.C. 1320d-8(a)) is amended, in the matter before paragraph (1)-- (A) by inserting ‘on behalf of an individual’ after ‘1978)’; and (B) by inserting ‘on behalf of an individual’ after ‘for a financial institution.’ (b) Standards for Claims Attachments and Coordination of Benefits - (1) STANDARD FOR HEALTH CLAIMS ATTACHMENTS- Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall promulgate a final rule to establish a standard for health claims attachment transaction described in section 1173(a)(2)(B) of the Social Security Act (42 U.S.C. 1320d-2(a)(2)(B)) and coordination of benefits. (2) REVISION IN PROCESSING PAYMENT TRANSACTIONS BY FINANCIAL INSTITUTIONS- (A) IN GENERAL- Section 1179 of the Social Security Act (42 U.S.C. 1320d-8) is amended, in the matter before paragraph (1)-- (i) by striking ‘or is engaged’ and inserting ‘and is engaged’; and (ii) by inserting ‘(other than as a business associate for a covered entity)’ after ‘for a financial institution’. (B) EFFECTIVE DATE- The amendments made by paragraph (1) shall apply to transactions occurring on or after such date (not later than 6 months after the date of the enactment of this Act) as the Secretary of Health and Human Services shall specify. Maybe my grasp on the english language just isn't that spectacular, but That certainly reads to me that there is intent to (a)Base your contribution by what you have (b)Lay the groundwork for rationing as stated "including whether the individual is eligible for a specific service with a specific physician at a specific facility" ©Allow the plan access to your funds automatically without your authorization based on the contribution the 'Secretary' deems you to be liable for. Feel free to give all of your money to the poor uninsured if you like. I would prefer to take the responsibility of my OWN healthcare. Without government meddling and without the taxation for zero liability voters that the left want to continue to ingratiate to themselves by expanding the WELFARE state. It's not rocket science. The people who have nothing at stake will vote the party into power that gives them the most 'FREE' stuff. This stuff isn't free. It's a burden put directly on the shoulders of working Americans. Show me proof? All I've seen is outdated census materials that included many medicare recipients as well as illegals in their numbers. Far from 50 million. Generic responses that aren't even related have almost become the rule. Such as the response I got when I sent a letter stating my position AGAINST the health care reform bill to the contact address for the White House. Dear Friend, If you’re like most Americans, there’s nothing more important to you about health care than peace of mind. Given the status quo, that’s understandable. The current system often denies insurance due to pre-existing conditions, charges steep out-of-pocket fees – and sometimes isn’t there at all if you become seriously ill. It’s time to fix our unsustainable insurance system and create a new foundation for health care security. That means guaranteeing your health care security and stability with eight basic consumer protections: No discrimination for pre-existing conditions No exorbitant out-of-pocket expenses, deductibles or co-pays No cost-sharing for preventive care No dropping of coverage if you become seriously ill No gender discrimination No annual or lifetime caps on coverage Extended coverage for young adults Guaranteed insurance renewal so long as premiums are paid Learn more about these consumer protections at Whitehouse.gov. Over the next month there is going to be an avalanche of misinformation and scare tactics from those seeking to perpetuate the status quo. But we know the cost of doing nothing is too high. Health care costs will double over the next decade, millions more will become uninsured, and state and local governments will go bankrupt. It’s time to act and reform health insurance, drive down costs and guarantee the health care security and stability of every American family. You can help by putting these core principles of reform in the hands of your friends, your family, and the rest of your social network. Thank you, Barack Obama The UNIONS have been destroying this country by beating the companies that drive our economy into submission while protecting the jobs of workers that don't deserve them for quite sometime. They are just as crooked they have been accused. Need proof? Ask my parents and many other people's parents that have had their medical coverage dwindle, and their pensions squandered leaving them with nothing when they are ready for retirement. The following about sums it up. Dear Citizens, Due to the current financial situation caused by the slowdown in the economy, I, President Obama have decided to implement a scheme to put workers of 50 years of age and above on early retirement. This scheme will be known as RAPE (Retire Aged People Early). Persons selected to be RAPED can apply to Congress to be considered for the SHAFT scheme (Special Help After Forced Termination). Persons who have been RAPED and SHAFTED will be reviewed under the SCREW program (Scheme Covering Retired-Early Workers). A person may be RAPED once, SHAFTED twice and SCREWED as many times as I, President Obama deem appropriate. Persons who have been RAPED could get AIDS (Additional Income for Dependants & Spouse) or HERPES (Half Earnings for Retired Personnel Early Severance). Obviously persons who have AIDS or HERPES will not be SHAFTED or SCREWED any further by me, President Obama. Persons who are not RAPED and are staying on will receive as much SH*T (Special High Intensity Training) as possible. I, President Obama have always prided myself on the amount of SH*T I give our citizens. Should you feel that you do not receive enough SH*T, please bring this to the attention of your Congressman, who has been trained to give you all the SH*T you can handle. Sincerely, President Obama PS - - Due to recent budget cuts and the rising cost of electricity, gas and oil, as well as current market conditions, the Light at the End of the Tunnel has been turned off. < Not really representative of our dear leader's words but pretty close to his message. >

I always like calls from my brothas. anytime.

Dodge the flying whip cream and laugh maniacally at the pillow fight target! P.S. HELL YES!

Pick Your Artist: Journey Are you male or female: Spaceman Describe yourself: La Do Da How do you feel about yourself: It's Just The rain Describe where you currently live: Mystery Mountain If you could go anywhere, where would you go: Seperate Ways Your best friend is: Raised on Radio Your favorite color is: Forever in Blue What's the weather like: It's Just The Rain If your life was a tv show, what would it be called: Positive Touch What is life to you: Daydream What is the best advice you have to give: Dont Stop Believing If you could change your name, what would it be: Evolution Your favorite food is: All That Really Matters

Black Label Society ~ live album

stare in amazement and ask for some amish style please.

I vote to skip the crossbow and get out the trusty buck knife. Tell him to man up.

Diet Redpop. Paper or plastic?

Argue over the difference between amish style or mustard potato salad.

http://www.youtube.com/watch?v=f046MhdnmQcLords of Acid ~~ Mr Machoman

+1 and eleventy billion more.

I just drove by there to get home from a job interview. I'd have given the groceries a ride if I'd seen him. I am kinda hungry.

Sassified.

WoW. I wish I could talk nature into delivering my food right to my porch too. NOM NOM NOM

Run from the police in a car that only does 15 mph.

I'd have posted this friday but I have been afk. Happy belated belated.

Exceptionally fat.

Ghostbusters would kick the ring's ass any day. They have a repurposed bambulance and big ghost laser thingies! And hannibal is the superior genius. He'd talk jigsaw into killin himself.

I would be a masked man that helped impregnate women that have problems getting knocked up. I would wear nothing but a glittery green mask.

I hadn't really considered the irony of that before. The picture doesn't really do that house justice. That blue was the most eliectric sear your eyeballs in the sunlight blue I have ever seen. it was just so unnatural!

Seems like he has a good handle on things.

Current favorite. Me doing what I do best. Being bad...

AW MAN! STOP TAKIN MAH PITCHER!