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The U.S. House of Representatives addressed the movement toward electronic commerce in early November when it passed legislation creating standards for electronic signatures and records.
"Electronic Signatures in Global and National Commerce Act" (HR 1714) would set national standards for electronic signatures and records and give them the same legal validity as written contracts and documents. It would prohibit the enactment of any state law denying the legality of agreements that are electronically signed.
The legislation passed by 356-66, enough to override a possible presidential veto. The administration has opposed sections of the bill, saying they would undermine consumer protections.
The Electronic Industries Alliance (EIA) in Arlington, VA, praised the House for its "overwhelming bipartisan vote" to approve the legislation. "Passage of HR 1714 is a critical step in establishing confidence in electronic commerce, which will promote jobs, stimulate the economy, and create savings and opportunity for America’s consumers," says EIA President Dave McCurdy, former chairman of the House Intelligence Committee.
The Department of Health and Human Ser-vices’ (HHS) Agency for Health Care Policy and Research (AHCPR) in Rockville, MD, has announced it is developing recommendations, or "guiding national principles," for helping institutional review boards and similar groups protect against the disclosure of personal health information in research that could be used to identify individual patients.
The recommendations will help provide guidance to research reviewers as they review research projects using identifiable information and as they implement the department’s privacy regulations mandated by the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Proposed regulations for this act were announced by President Clinton on Oct. 29, 1999. Under HIPAA, a final rule is to be issued by Feb. 21, 2000, with a two-year implementation period for most covered entities.
The guiding national principles will be based on a study by the Institute of Medicine of the National Academy of Sciences in Washington, DC, which is expected to be completed in the summer of 2000. HHS’s Office of the Assistant Secretary for Planning and Evaluation is co-funding the contract with AHCPR.
In October, the Department of Health and Human Services announced the Part B premium paid by Medicare beneficiaries this year will remain unchanged for the second time in three years.
The Part B premium covers physician services, hospital outpatient care, durable medical equipment, and other services outside hospitals. The Part B premium will stay at the 1999 rate of $45.50. Last year, it rose by $1.70.
The Medicare Part A deductible for inpatient hospital care is rising by $8, about 1%, to $776. Last year, the deductible rose by $4. The Part A deductible is a beneficiary’s only cost for up to 60 days of inpatient care. The cost to beneficiaries for hospital stays longer than 60 days is rising by $2, to $194 per day, and by $4, to $388 per day, for stays longer than 90 days. The skilled nursing facility deductible, which must be paid after the first 20 days of such care, is rising by $1, to $97 per day.
In addition, the premium for Part A coverage for the 365,000 beneficiaries who pay it is dropping in 2000. The full monthly Part A premium is dropping by $8, to $301. It is paid by seniors with less than 30 quarters of Medicare-covered employment and by disabled individuals under 65 who lost disability benefits because of work and earnings. Seniors with from 30 to 40 quarters of Medicare-covered employment are entitled to reduced premiums that are dropping by $4, to $166.
The Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, announced Nov. 8, 1999, that it would increase the fees for its periodic full surveys by 3.25% in all but its Ambulatory Care and Home Care programs. The fee increase, which became effective Jan. 1, 2000, was approved by the Board of Commissioners at its Nov. 5-6, 1999, meeting. The board also acted to reestablish a $2,500 fee for follow-up focused surveys to offset the actual costs of conducting these surveys.
The Joint Commission last adopted an across-the-board survey fee increase in 1994. The overall fee for a full Joint Commission survey is generally derived from a base fee, a service-volume related fee, and the application of a survey price ceiling. The price increase will apply to all of these fee components.
In 1995, the Joint Commission eliminated its separate charge for focused surveys but did not increase overall fees to cover the costs of these surveys. In reinstating a charge for these follow-up surveys, the Board of Commissioners determined that the related costs should be borne principally by those organizations requiring focused surveys, rather than spreading these costs across the fees for all accredited organizations.
The Board of Commissioners also acted to eliminate Accreditation with Commendation as an official decision category, effective Jan. 1, 2000. Accreditation with Commendation was introduced in January 1991 to recognize exemplary performance in accredited organizations at a time when performance reports were not available.
Recent experience had suggested that the Accreditation with Commendation decision category was leading organizations to place undue pressure on their senior management staff to achieve Commendation and to seek to influence surveyors not to cite them for insufficient compliance with Joint Commission standards.