Final Regulations on HIPAA

Two HIPAA final regulations were published in the February 20th Federal Register regarding Security Standards and modifications of the Transaction Standards.

Final privacy standards have already been adopted by the Department of Health and Human Services and take effect April 14th.

The Security Standards require all covered entities to implement administrative, physical, and technological safeguards to protect electronic health information. These Security Standards take effect April 21, 2005 for all covered entities (except small health plans, which have an additional year to comply).

The Transactions Standards cover electronic healthcare transactions and code sets. All covered entities must begin software and systems testing by April 16th.

View these rules at: www.cms.hhs.gov/hipaa/hipaa2/default.asp.

Sign up for HIPAA e-mail alerts at: aspe.hhs.gov/admnsimp/lsnotify.htm.

Workplace Illnesses and Injuries Hit Record Low in 2001

On December 19, 2002 United States Secretary of Labor Elaine L. Chao announced that the 2001 workplace injury and illness rates had hit a record low.

"Today’s announcement of continued decline in workplace injuries and illnesses is good news for America’s working men and women, their families, and their employers," said Secretary of Labor Chao. "Workplace injuries and illnesses have dropped for the ninth consecutive year, reaching an all-time low. Construction injuries are down. And there has been a 10% reduction in repeated trauma injuries, such as carpal tunnel syndrome and other musculoskeletal disorders."

The decline affected both the rate and the number of injuries. The number of injuries and illnesses declined from 5,650,100 in 2000 to 5,215,600 in 2001. This represents a 7.69% decline, dramatically larger than in the preceding years (see Figure 1).

The injury and illness rate also declined to 5.8 injuries and illnesses per 100 workers. This rate continues its dramatic decline (see Figure 2).

For additional information, visit www.bls.gov/iif/home.htm.

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Clarification of New OSHA Hearing Requirements

On January 1, 2003 occupational health programs around the country began switching their analyses of audiograms for OSHA hearing conservation programs. On July 1, 2002 OSHA had published OSHA’s Final Rule on Recording Hearing Loss in the Federal Register. This is a revision of the hearing loss provisions of the Occupational Injury and Illness Recording provisions of the Occupational Injury and Illness Recording and Reporting Requirements rule published January 19, 2001.

On December 11, 2002 OSHA clarified three matters in relation to recording occupational hearing loss.

The preamble to the final rule stated that employers in the shipbuilding industries are not covered by OSHA’s noise standard §1910.95 and are therefore not required to perform audiometric tests. This statement was an error. OSHA Directive STD 0.2 Identification of General Industry Safety and Health Standards (29 CFR 1910) Applicable to Shipyard Work specifically states that employers in the shipbuilding industry that are covered by the 29 CFR Part 1915 Standards are required to comply with a number of 29 CFR Part 1910 standards, including the §1910.95 requirements for occupational noise.

The second issue involves the computation of a Standard Threshold Shift (STS), which is one part of the two-part recording criteria recently published (67 Fr 44037-44048). OSHA’s former recording criteria required the employer to track separate baselines for recording and hearing conservation purposes. However, the new Part 1904 hearing loss recording system relies on the existing 1910.95 calculations, and separate baselines will no longer be required.

In short, if an employee’s audiogram reveals that the employee has experienced a work-related STS in hearing in one or both ears, and the employee’s total hearing level is 25 decibels (dB) or more above audiometric zero (averaged at 2000, 3000, and 4000 Hz) in the same ear(s) as the STS, you must record the case on the OSHA 300 Log.

OSHA has noted concern among employers because the application of the new two-part test in the new §1904.10 recording criteria will result in an increase in recorded hearing loss cases. As noted in the July 1, 2002 rulemaking, the new criteria will capture more hearing loss cases. Employers will experience an increase in recorded hearing loss cases in 2003 and future years. Caution must be used when comparing the 2003 and future data to prior years, when the 25 dB criteria for recordkeeping was used. OSHA recognizes this increase, and will take the changes in the recordkeeping rule into account when evaluating an employer’s injury and illness experience.

On additional area that has confused some programs is that OSHA has delayed, until January 1, 2004, a modification of the OSHA 300 log that requires employers to check a hearing loss column to record work-related cases of hearing loss. Although the new column takes effect in 2004, the new criteria for determine hearing loss takes effect on January 1, 2003.

For additional information:

www.osha.gov

www.osha.gov/recordkeeping/clarifications-recordkeeping.html

www.systoc.com/outcomes_protocols/hearing.htm

www.systoc.com/Tracker/Winter02/TrackerArticles/OSHA.asp