CMS Unveils HIPAA Complaint and Testing Website > Michigan State Medical Society


CMS Unveils HIPAA Complaint and Testing Website

The Centers for Medicare & Medicaid Services (CMS) released an updated website where providers and others can lodge complaints against a HIPAA covered entity (including health plans and clearinghouses) for potential non-compliance with the administrative simplification provisions of HIPAA and the Affordable Care Act. The Administrative Simplification Enforcement and Testing Tool (ASETT) enables individuals or organizations to file a complaint in the areas of electronic transactions and supporting operating rules (such as electronic funds transfer), medical code sets such as ICD-10, and unique identifiers (i.e., national provider identifier). The ASETT system captures required demographic information about the complainant and the filed-against entity, details of the alleged violation, and any supporting documentation. When filing a complaint, the complainant has the option to remain anonymous to the filed-against entity.

This ASETT system also facilitates testing of HIPAA 5010 electronic transactions and operating rules for compliance, syntax, and business rules. In addition, providers can validate code values against 60-plus clinical and non-clinical code sets, including ICD-10 diagnostic and inpatient procedure code sets. CMS would then reply with acknowledgment transactions and reports to help identify and resolve errors.


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