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HomeMy WebLinkAboutAgenda - 09-17-2002 - 8g 1 ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: September 17, 2002 Action AgerWa Item No. SUBJECT: The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Electronic Health Care Transactions and Code Set Standards, Compliance Deadline Extension, and Selection of the County as a "Hybrid Entity" Under the Act DEPARTMENT: Health PUBLIC HEARING: (YIN) No ATTACHMENT(S): INFORMATION CONTACT: Resolution Rosemary Summers, ext 2412 Background Report Sean Borhanian, 732-2196 Compliance Schedule TELEPHONE NUMBERS: Hillsborough 732-8181 Chapel Hill 969-4501 Durham 688-7331 Mebane 336-227-2031 PURPOSE: To consider a resolution to designate Orange County as a "Hybrid Entity" for purposes of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and to authorize the Director of the Health Department to file a plan that enables the compliance deadline to be extended until October 2003. BACKGROUND: HIPPA is intended to protect the health insurance rights of workers who change jobs and provide enhanced enforcement of health insurance fraud and abuse laws. Regulations address three primary areas: electronic information sharing; patient privacy; and . security of health information. A number of County Departments provide health care services, such as the Health Department and Orange County EMS, and bill services in electronic form. The Orange County Health Department has spearheaded an interdepartmental workgroup of County employees to study the initial impact of HIPAA on policies and procedures of departments to which HIPAA may apply, and help determine next steps to ensure compliance. (See Background Report and Proposed Compliance Schedule attached). The consensus of affected departments, in consultation with the County Attorney's Office, is to request designation as a "hybrid entity". HIPPA privacy rules define a "hybrid entity" as a "single legal entity whose business includes covered and non-covered functions" provided that the "health care components" are not the principal mission of the entity. "Hybrid entity" status will allow the County to distinguish its "health care components" that are subject to the HIPPA privacy rules and exempt others. The first deadline for compliance or a plan for compliance for County Departments that electronically bill for medical services is October 16, 2002. 2 FINANCIAL IMPACT: There is no immediate impact. However, the financial impact to the County of auditing existing County practices and implementing new policies and procedures that may be required to bring the County into compliance with the various components of the HIPAA rules in conjunction with other applicable federal and State laws may be substantial and are yet to be determined. RECOMMENDATION(S): The Manager recommends that the Board: • Resolve to designate Orange County as a Hybrid Entity for purposes of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and • Authorize the Director of the Health Department to file, on behalf of the County, a compliance plan that sets October 2003 as the compliance deadline for HIPAA's standard medical billing code set requirements. 3 ORANGE COUNTY BOARD OF'COMMISSIONERS RESOLUTION DESIGNATING ORANGE COUNTY AS A HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT HYBRID ENTITY WHEREAS, the Orange County Health Department has established an interdepartmental workgroup (HIPPA Workgroup)to conduct an initial study of the impact of the 1996 federal Health Insurance Portability and Accountability Act on the policies and procedures of various departments of Orange County and to help determine the steps necessary to ensure that the County complies with the applicable federal and state laws and regulations relating to the use, maintenance and disclosure of protected health information, and WHEREAS, the Orange County Board of County Commissioners desires to designate Orange County as a Hybrid Entity as defined in the regulations and to take advantages of the benefits such designation confers; NOW, THEREFORE, BE IT RESOLVED that Orange County shall be designated as a Hybrid Entity as defined in the regulations for purposes of Health Insurance Portability and Accountability Act compliance; and BE IT FURTHER RESOLVED that the Hybrid Entity is entitled to enjoy the benefits such designation confers; and BE IT FURTHER RESOLVED that the Orange County Board of Commissioners and officers of the Hybrid Entity are hereby authorized and directed to take such actions as may be reasonably necessary to facilitate such designation. This the 17'" day of September, 2002. 4 Background Repbrt Health Insurance Portability and Accountability Act of 1996 (HIPAA) Congress passed the Health Insurance Portability and Accountability Act of 1996 (HIPAA) in response to requests for standardization of the electronic health care payment process. HIPAA was meant primarily to protect the health insurance rights of workers who changed jobs and to provide enhanced enforcement of health insurance fraud-and-abuse laws. HIPAA also included, however, "Administrative Simplification" standards that directed the U.S. Department of Health and Human Services (DHHS) to publish regulations concerning the interchange and protection of health information data. The federal DHHS has already issued three sets of regulations in final form (e.g., transactions and code sets, provider identifiers and privacy rules) and others (e.g., security rules) are in process. The Administrative Simplification regulations, finalized so far, include the following: • Electronic Data Interchange (EDI)—The Health care industry uses many different electronic formats and codes to exchange health information for billing and other purposes related to payment. The goal of the HIPAA provisions are to standardize the form and codes involved in these electronic transactions and thereby decrease the administrative costs of health care billing. The regulation includes, for example, uniform codes for diagnoses or medical procedures that are used to transmit health information. County Departments that electronically bill for medical services must come into compliance with this portion of the regulations or submit a plan for compliance by October 16, 2002. The compliance plan may be submitted by the "Covered Entity", as defined below, by filling out a "Model Compliance Plan" consisting of a fairly routine intemet-based (online) questionnaire form (attached to this report). • Privacy Rules—The privacy regulations provide a comprehensive set of rules for the use and disclosure of patient identifying health information and establish new patient rights with respect to Protected Health Information (PHI), including new disclosure authorization, consent and notice rights. Covered entities must comply with their requirements by April 14, 2003. See the next page for a chart that details the initial timeline on achieving compliance with the current regulations. 5 INITIAL PROPOSED HIPAA COMPLIANCE SCHEDULE Action Dates Health department as beta tester for state assessment flow May 2002 instrument Health department designated Privacy and Security Officers for the June 2002 department to participate in statewide training Formation of"HIPPA Workgroup"—to conduct an initial study of August 2002 HIPAA as it applies to Orange County. Identifying the "Covered Entity" -- Orange County Board of County September 17, 2002 Commissioners decides whether the County will be treated as a Hybrid Entity. The "Covered Entity" files an Electronic Date Interchange Must be filed prior to Compliance Plan to request that the deadline for the County to October 16, 2002 comply with HIPAA's new standard medical and billing code sets be postponed to October 2003. Designating a "compliance officer(s)" and/or"privacy officer(s)" and appointment of a HIPAA Compliance Committee as may be required by the privacy rules. Baselining the Agency— Identify protected health care information maintained by County Departments and the flow of such information, within the agency, between agency, and outside associates Gap Analysis — Compare HIPAA privacy requirements with all Deadline, April 2003. existing health care information privacy laws; compare HIPAA privacy requirements with existing privacy-related policies, procedures, practices and forms. Identify new policies required and obsolete policies to assure complete compliance with HIPAA and any more stringent state laws. Develop a work plan and budget to achieve HIPAA compliance. Implementation — Conduct HIPAA awareness training for the effected County Departments as required; create new policies and forms identified through the Gap Analysis; implement new policies. Maintaining Compliance — Develop and implement ongoing training program for new and existing employees, an internal audit program Ongoing to ensure ongoing HIPAA compliance. Information Flaw Assessment QuesSonnaire b + A. INFORMATION CREATED,RECEIVED,SENT AND/OR STORED Identity those items that contain health informadon,which you currently create,receive,send and/or store in your area. If your workgroup does not create. receive,send and/or store health information than select none and continue to the next section,^.. Check(✓)all options that apply for each column. If description or option that applies to your workgroup is not listed under a category to the description listing in the blank line at the end of each category table. Storage is defined as health intormation retained in your work area for more than 30 days, To complete the Storece information columns.use one or aAof the toilowing options as aoproodaW •Under the Type column use O for Original and C thr Copy. •Under the Format column use P forpaper and E for electronic. •Under the How Stored column use the Storage fist on page.15 to list the appropriate number(s), 1.Administrative Storage Information Description Create Receive Send Store Typ e Format I Now Stored O C P E Use list Accident R2Mrtsjrpr client Application for Admission Cancer Registry Certificates Birth,Death,Other Complaint Information Correspondence,Memos Internal&External Criminal Background Checks Incident Reports Investigative Reports Abuse,Ne loot,Other Leaai Papers CommitmenUCustod /CourtlOther Logs Clients,Notes,Correspondence,Other) Meeting MinuteslNotes Photographs Questionnai res - - None( to next section) - 2.Education(Institutions,Schools) Storage Information Description Create Receive Send Store T e Format How Stored O C P E Use list Behavior Rating Scales Education Plan Questionnaires None o to next section) 3.Financial Storage Information Description Create Receive Send More Type Format Now Stored O C P E Use list 13ankinglDirect Deposit Billing/Remittance Advices CAP or Respite Determinations Claims Irtfc^nation Insurance,Billing) Conesponuence Funding Justifications with Details Grants,etc.) Questionnaires,Forms,Other(i.e.,Medicaid he( o to next section July 2001-Version 4 HIPAA 2 Information Flow Assessment Questionnaire 7 4.Employee/Stan Information Story e Information Description Create Receive Send Store Type Format How Stored O C P E Use list lications/RSsum§s Disability Claims&Reports Disciplinary Action Employee Assistance Program Information Em b HeaRh Records Health Plan Enrctlment Information Ph ician Notes Absences from work Referenoe Letters Voluntary Shared Leave Worker's Compensation Claims&Reports None o to next section 5.Social Programs Storage Information Description Create Receive Send Store Type Format I How Stored plicationslFormsJ Eligibility Information O C P E Use list Case Consultation Notes Correspondence Loo Services,Cases,Other Meetin Notes/Minutes ,Summary Review Reports None jgo to next section 6.Utilization Review Story e Information Description Create Receive Send Store Type Format How Stored O C P E Use list Correspondence FL-2/MR-2 Forms Los Services,Cases,other Meetin Notes/Minutes Worksheets,Revievis,Reports None to next section 7.Clinical Information Storane Information Description Create Receive Send Store Type Format I How Stored O C P E Use list Complete Medical,Dental Record or Client File Death Medical Records Partial Clinical Information Including: Assessmentslftports Dental Records Dia gnosis/Procedure Description/Name Discharge Summary Doctors Statements for Court Exams/Evaluations/AssessmentsMistories Habilitation Plans Immunization Records Laboratory Data Jury 2001-Version 4 HIPAA 3 Information Flow Assessment Questionnaire 7.Clinical Information(Continued) Storage Information Format How Stored Description Create Receive Send Store O C P E Use list Logs ShiftlStaff Notes Insurance,Other Medication Administration Medication Error Reports Nurses Notes Pathology Repolts Physician Orders Progress Notes - Ps hological Records&Testing Re orts Psychotherapy Notes . Radiology Reports Referral Information Training Programs Treatment Plan X ra Fltms None o to neat section S.Diagnosis/Procedure Codes Specify your source(s)for diagnosl&/vocedure codes in the following table: Specify Reference ✓ CDT(American Dental Association[ADA)Codes,'Code on Dental Procedures and Nomenclature' CPT(AMA,'Current Procedural Terminology Coding,Fourth Edition' - DSM-IV(American Psychiatric Association,'Diagnostic and Statistical Manual of Mental Disorders,4th Edition ICD-9-CM,Vol.1&2(Intemational Classification of Diseases,9th Edition, . Clinical Modification,Volumes 1 and 2) - ICD-9-CM,Vol.3(International Classification of Diseases,91h Edition, Clinical Modification,Volume 3 HCPCS HCFA,'Common Procedure Coding System') HCPCSJ-Codes HCPCSPharmac Codes Local Codes W and Y Codes NDC HHS,'National Drug Codes' None go to next section s. Transactions For the transactions listed below,specify whether health information is created,sent,received,or stored electronically(E), on Paper(P),andorby Voice(V). Voice includes the following: face-to-face,phone,or voicsmail. Select all that apply. Description Create Receive Send Store E P V E P V E P V E P V Authorization for Services Coordination of Benefits Eligibility Information Enrollment and Disenrollment-health plan First Report of Injury Health Care Claim - Health Care Claim Status Health Care Payment and Remittance Advice Health Claims Attachments Health Plan Premium Payment None go to next section Juhr 2001 Version 4 HIPAA 4 ' 9 Information Flow Assessment Questionnaire 10. Electronic Systems Select the current system(s)1application used by your workgroup from the list below. For each system selected,indicate if the system can be accessed from an area other than the worksite and,if so,how the system is accessed. if a mode of - access that you use is not listed,write-in the mode of access in the Other column. ❑ None(go to next section) DIVISION/SYSTEM Remote Access Check Access Mode Use YES I NO ji Dial.in I Terminal 1pcianutaW Data Line I Other DCD Subsidized Child Care DEIE HSIS POMCS SIMS DFS Coro iairn Tracking System Enterprise Provider Pre-Hospital Medical Information System DMA CNDS Drive EIS EPICS IEVS MMIS DMH/DDISAS ARC-At Risk Children COW-Consumer Data Warehouse CNDS. Drive DSS EIS Enterprise Provider HEARTS HUB IPRS - MAA/MHA-Cost Accounting MMIS MR/MI PDS PFS PIONEER POMCS QED DOA ARMS OmBudsman System DPH BMAX from Cigna) CACFP CCDS Clinical Fusion former) Kaplan) Dusty Trades EBC EBC/ECODE EBC/RECEIVE EDS EIS Genetic Counseling HARS Jnw Vaal-Wminn S H±PAa Information Flow Assessment Questionnaire 10 WSIS J„w 2001.version 4 HiPAA 6 .......... =9 Blum BIF&...... MW Information Flow Assessment Questionnaire Current systems used(continued). DIVISIONJSYSTEM Remote Access Check Access Mode Use YES I NO Dial-in I Terminal IPCJEMuI4 Data Line I Other DVR CRPBud et-VWA DVR-VRA EIS POMCS Service Reporting-VRB Social Seourfty Reimbursement-VIA VCM VRSatchClientData-VRA IMS VR Online Client Data-VRAIVCA Office of Controller Child Placement&Payment System County Admin. Energy HEARTS Transaction Billing System WPPS Other S COMMENTSIADDITIONAL INFORMATION: July Zaat-Version 4 HIPAA . $ . 13 Information Flow Assessment Questionnaire B.ACCESS TO HEALTH INFORMATION 1.Building Identify only those persons who have access to your wankgroups physical location and to the health information maintained by your workgroup.Specify their type of access by populating the Access columns with one of the following options:Unlimited(U)or Limited(L). Access Who Within Bldg. Whin Ghent Work Areas Contractors Administrative Clinical Employees and Cou !State .. 7em General He Famil !Friends,etc. Professionals Attome Auditors Volunteers Trainin lin-servicelintemshi Doctors Nurses Students 2.Location Identify the physical site(s)where health information may be located in your workgroup's area. Speedy with a check made (✓)by the appropriate options.For each storage mechanism listed you may select more than one site(e.g.,Hallway and File Room)_ Spec! ✓ STORAGE MECHANISM 0 sa atl 8scontl shared Prr a MM Fi HWMW c=Mn Wont Work Area A. R mm -Wom Area Ama Com uter Co ier Fax File/Storage Cabinets Off-site Home Office,Car,Briefcase O n SheiveslBookcase Printer R cle Container Shredder ,J U1Y 2001•version 4 HIPAA 9 Information Flow Assessment Questionnaire 3.Access Control Identify wefts controls that are in place for protecting health Infonna8on maintained in your work area. Select all that apply by placing a check mark(/)by the appropriate listing. Check Current Access Controls (�) Identification Badges Optical Recognition Fingerprint Passwords Staff Escort Visual Recognition Observation Employee monitored areas Onsite Security Force-Armed - On-site SeCUM Force-Unarmed Surveillance-24 hrs. Camera,Motion,Heat Surveillance- After Hours AlarmlMonitor - Rees Klon Area Reco ticnistiGuardiinrarmabon Sign-in/out Register Monitored Sign-in/out Register Unmondored Physical Barriers Counter/Desk/Table Doors Open Closed unlocked Locked-Card Swi Locked —CambinationKe Pad Locked-Ke PenitionslMoveable Dividers Glass(Stationary or Moveable Wall Hours Closed(Open by Request Only) Open 247 HouralDa ) . Open Days(Monday Through Fridayl Open Days(Mmday Through Saturday) O n Evenings&Weekends Only Open Evenin s Only- Open Variable Hours/Days Other . Other Controls $ ecl COMMENTSIADDITIONALINFORMATION: July 2001-Version 4 HIPAA 10 ►5 Information Flow Assessment Questionnaire C. HEALTH INFORMATION SOURCES Identify agencieafaouree(s)that send or receive heats infonmadon to/ham your wodrgroup.Identify wheihersuch transmissions are on paper,electronic,fax or phone by placing a check mark(-1)in the appropriate columns. You may check more than one option for each source. If none apply,leave the column blank. SOURCES Send Receive I Paper I Electronic E Fax Phone In anent Facilities ' General Hospitals Rehabilitation Centers Nursing Homes VA Hospitals Psych iatric Hospitals Special Care Centers MR Centers Other(Specify Residential.Facilities Alternative Family Livin Apartment Living Assisted Living Family Care HometGroue Home Su rvised Living Train School Other S Education Facilities Governor Morehead School Public or Private Schools School for Deaf/Hard of Hearing Wright or Whitaker School Other(Specify OutpatientlDay Services Adult Day Care Child Day Care Community Clinics Developmental Evaluation Centers Em lo ee Assistance Program Hospital Ou tient Metal Huth Center/Area Program Public Health Dept Rehab Centers Sheltered Worksho Urgent Care Cater Other(SRM Social Services Child Fatality Prevention System Child Fatality Task Force Child Support Enforcement Child/Adult Protection Services Dept of Social Services Foster Home Other Spec July 2001-version 4 HIPAA 11 Information Flow Assessment Questionnaire 10 SOURCES I Semi Receive Paper Electronic Fax Phone Private Practice Attorney Audiologist Chiropractor Dentist HMO/PPO Physician Private Allied Health Specialist Social Worker, Nutritionists Ps eholo ist Thera isf Occu „Speech,Ph I, Psych.) Other S eci Law Enforcement Attorney General's Office Clerk of Court Court District Attorney Law Enforcement Officer/Sheriff/Police Local Jail/Detention Center Parole Officer/Probation Officer Prison(Correctional Facility Other S ecif Financial Auditor Bank Billing/Collection Service Court Estate Payer/insurance Company Other S cl Additional Clearing house Client Contractor Coroner Dept./Div/Office Public Information Officer Employees Employers Family/Guardian Friend/Neighbor Funeral Homes Guardian Ad Litem Health Plan Legislatc,r State&Federal Media Radio,N,Newspaper,Web,etc. Other State Agencies Out-of-State Aqencies Researchers or Research Facility ReviewlOversi hl Boards/Committees Trans ort(Ambuhance.Providers Vendor Other(Specify COMMENTSIADDITIONAL INFORMATION: July mst-venuan 4 HIPAA 12 17 Information Flow Assessment Questionnaire D. INFORMATION TRANSMISSION Identify all methods of transmission utilized by your workgroup for sending and receiving health information by checking the appropnate,boxes. For each method selected,indicate with a cheek mark(,)if you retain a copy of the information in the Ratak Copy column. Transmission Method Send Receive Retai e Electronic Electronic Transaction via FTP E-mail Floppy Disk/CD/M netic Tape LANANAN network Modem OCR scanned Software ApplicaWntSystern Web Site Paper Courier/Fed ExA PSIAirborna/Eme /others Envelo older,Sealed rmnvelopeffiolder,Unseated FAX Machine Hand Delivery(person to person) LogslJournals Mail,Interoffice Mail,US Postal Medical Record File Voice[Visual Face to Face Pager Phone,CelUSatellfte Phone, Land Line Photographs SecuntX Camerafrapes Tape Reel to Reel,Cartridge) Video Tapes Web Cam Other S tdentry all methods of recording heamh hnormaton received verbally by your workgroup.Check all that apply. Check Recording Method Dictate to Machine,Computer,Person Enter in PC Message/Memo Note in /Journals Informal Staff Notes Medical Record Form - Scratch Pad/Post-ft Note - Cassette Ta CD Message Center Voice Mail Other S 'f duty 211011•Versian 4 HIPAA 13 Information Flow Assessment Questionnaire E. DISPOSAL METHODS Identify disposal methods of heaitir Information maintained in your woligroup. Check all that apply. Check Disposal Methods ✓ Empty Electronic Trash - Pre are and Send to Permanent Storage Rec de Container Shred Throw in Trash Other S ec F. BUSINESS ASSOCIATE IDENTIFICATION This section assists you in identifying your business associates. A Business Associate is a person,organization,or business who performs a function or activity on behalf of your omanization. A Business Associate excludes a person who is part of the covered entitys wa d,broe.If this sections does not pertain to your workgmup,write None in the first row and continue to the next section. List all contractors, vendors or service providers who provide a service on behalf of your agency. Contractor Name Services Provided Jury 2001•Version 4 HIPAA 14 Information Flow Assessment Questionnaire G. GENERAL COMMENTS AND ADDITIONAL INFORMATION List any comments, concems and/or additional bIbrmation that you have as a result of completing this Information Flow Assessment Questionnaire. July 2001-version 4 HIPAA 15 a � Information Flow Assessment Questionnaire Storage List for Use with Section A, pages 2-4. This listing of methods of storage is to be used when completing section A, "Inthrmadon Created,Received, Sent andror Stored"on page 2. Each method or place of storage is numbered. Under How stored wdte-in the number(s)that corresponds to the method4ocadon of storage. You may add otherstorage methods if they are not listed,by continuing with the numbering sequence(i.e.,40). HOW STORED # Bookshelf/Open Shelf Files 1 Boxes-Sealed 2 Boxes-Unsealed 3 Bulletin Board 4 Cassette Tae Locked Area 5 Cassette Tae Unlocked Area a Closet/Room/Storage Area Locked 7 ClosetlRoom/Stora eArea, Unlocked 8 Contractors e. ., EDS MRNC Consultec 9 Desk Drawer Looked 10 Desk Drawer Unlocked 11 Desk/Table Top 12 Disks-Floppy or CD, Locked Area 13 Disks-Floppy or CD, Unlocked Area 14 E-mail-Network 15 E-mail—PC 16 Envelopes-Sealed 17 Envelopes-Unsealed 18 File Cabinet Locked 19 File Cabinet, Unlocked 20 Folders-Electronic 21 Folders-Paper 22 Magnetic Tape/Data Cartridge 23 Mailboxes In/Out 24 Mainframe 25 Microfilm/microfiche 26 Network ArchivalStorage 27 Network Backus 28 Network Server 29 Network, Personal Drive 30 Network Shared Drive 31 Notebooks 32 Off-site Store a Electronic 33 Off-site Storage(Paper) 34 PC Local Drive C 35 Portable Cart 36 State Records Center 37 Vault 38 Voice Mail 39 July 201•vemlon 4 HIPAA 18 a � Information Flow Assessment Questionnaire ACRONYM LIST ACTS Automated Collections Tracking System AMA American Medical Association ARC At Risk Children CAP Community Alternative Program CD Compact Disk CDT Current Dental Terminology COW Consumer Data Warehouse CNDS Common Name Database Service CPT Current Procedural Terminology DCD Division of Child Development DEIE Division of Early Intervention&Education DFS Divisions of Facility Services DMA Division of Medical Assistance DMH/DD/SAS Division of Mental Health/Developmental Disabilities and DOA Division of Aging OPH Division of Public Health DSB Division of Services for the Blind DSD&HH Division of Services for the Deaf and Hard of Hearing DSS Department of Social Services(State level) Division of Social Services(County level) DVR Division of Vocational Rehabilitation EIS Eligibility Information System EPICS Enterprise Program Integrity Control System FL-2/MR-2 Forms Forms utilized by Medicaid for level of care determined for Intermediate Care, Skilled Care or Intermediate Care Mental Retardation FSIS Food Stamp Information System FTP File Transfer Protocol HCFA Health Care Financing Administration HCPCS HCFA Common Procedural Coding System HEARTS Healthcare Enterprise and Accounts Receivable Tracking System HHS Health and Human Services HIPAA Health Insurance Portability Accountability Act HMO Health Maintenance Organization International Classification of Diseases—Ninth Revision— ICD-9-CM,Vol. 1&2 Clinical Modification (Diagnostic Classification) International Classification of Diseases—Ninth Revision— ICD-9-CM,Vol. 3 Clinical Modification(Inpatient Procedures) IEVS - Income Eligibility Verification System IPRS Integrated Payment&Reporting System A subset of the HCPCS Level II code set with a high-order value of OX that J-Codes has been used to identify certain drugs and other items LAN Local Area Network MMIS Medicaid Management Information System MR Centers Mental Retardation Centers NDC National Drug Code OCR Optical Character Recognition Open 2477 Open 24 hours a day, seven days a week. PC Personal Computer PPO Preferred Provider Organization QS Quantum Sufick SCELL Sickle Cell SISICARS Service Information System/County Administration Reimbursement System TB Tuberculosis TIMS Telecommunication Information Services UPS United Parcel Service VA Hospitals Veteran's Affairs Hospitals VR Vital Records WAN Wide Area Network July 2001-Version 4 HIPAA 17 as Information Flow Assessment Questionnaire WIC Women, Infants, Children 'July 2001.Voslon 4 HIPAA is