Uniform National Standards Research Articles

An Introduction to the Health Insurance Portability and Accountability Act of 1996 Administrative Simplification

On August 21, 1996, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) was signed into law. One part of the law requires the adoption of uniform national standards for health information, establishing how information should be formatted, shared, and protected. This will affect every aspect of pediatric practice, and you should begin now to understand HIPAA. Over the next 2 years, the American Academy of Pediatrics (AAP) will develop summaries and sample materials to help you incorporate these requirements into your practice.Standardization of electronic transactions in health care will greatly facilitate the sharing of data, raising concerns about how the data will be protected. HIPAA required the first-ever national standards for privacy protections of health information. The privacy rule establishes significant restrictions on the use and release of medical records, describes privacy safeguard standards that must be met, gives patients several important rights, and provides for significant penalties for misuse of health information. In addition to concerns about privacy of health information, increased exchange and compilation of electronic health information raises concerns about physical and technical security. HIPAA requires the adoption of a national standard for security of electronic health information. The 1998 proposed rule describes minimum security requirements and requires each health care organization covered by the rule to designate a security official.The core element of administrative simplification is to require the use of a single standardized format for 10 common health care transactions including health care claims, eligibility inquiries, referral certification and authorization, and payment. In these transactions the use of specific clinical code sets, including Current Procedural Terminology and International Classification of Diseases, Ninth Revision, Clinical Modification is required. The use of national standard identifiers for providers, health plans, and employers will also be required.The requirement for a national identifier for individuals has been extremely controversial, and in the fall of 1998, Congress prohibited the promulgation of a national patient identifier.The AAP expects that most pediatricians will be covered by HIPAA because they submit electronic claims themselves and/or use a billing service or clearinghouse to convert paper claims to electronic format. The HIPAA administrative simplification provisions apply to the following covered entities:Final rules have been published on standards for electronic transactions and privacy of health information. Covered providers must comply with the transactions rule by October 16, 2002, and with the privacy rule by April 14, 2003. Proposed rules on security, national provider identifiers, and national employer identifiers were published in 1998. No other proposed or final rules have been published yet, and the US Department of Health and Human Services has no expected date for publication.The AAP will continue its efforts to educate pediatricians about HIPAA and to advocate for HIPAA implementation that works for children’s health care. More information on HIPAA is available on the AAP Members Only Channel (http://www.aap.org/moc). In the future, this Web site will contain pediatric-specific compliance guidance and model policies and procedures. In addition, future issues of this newsletter will contain articles focusing on specific aspects of HIPAA implementation.For more information about HIPAA and its effect on pediatricians, e-mail HIPAA@aap.org, or call the AAP Division of Health Care Finance and Practice at 800/433-9016, ext 4089.

Diversity in Australian Local Government: The Case against the Imposition of Uniform National Standards

Over the past several years, numerous official and other bodies have called for the imposition of a uniform set of national standards for Australian local government. It has been argued inter alia that uniform national standards would facilitate benchmarking and other performance comparisons across local government jurisdictions. Whilst there is undoubted validity in principle to the contention that benefits would flow from a uniform national approach to local government, these arguments nevertheless ignore the tremendous diversity characteristic of Australian local government. This paper seeks to demonstrate that local government in Australia exhibits a large degree of diversity both within and between states and territories. Moreover, we attempt to show that inexorable demographic, employment and infrastructural trends are underway which will ensure that the diversity will not only continue, but also increase. Accordingly, although the imposition of uniform national standards may seem attractive at first sight, the actual implementation of these standards seems to be neither feasible nor desirable.

Integral Abutment Bridges: Current Practice in United States and Canada

Integral abutment bridges have been gaining popularity among bridge owners as cost-effective alternatives to bridges with conventional joints. They reduce initial construction costs and long-term maintenance expenses, improve seismic resistance, and extend long-term serviceability. New York has been building them since the late 1970s, with a wide variety of details, and they have been performing well. For further improvement of New York’s design practice, a comparative survey was undertaken across North America, focusing on design and construction of both substructures and superstructures. In all, 39 states and Canadian provinces responded, including 8 who said they had no experience with these bridges. Responses are analyzed and summarized in this report. Overall, integral abutment bridges are performing as well as, if not better than, conventional bridges, but no uniform national standards exist for their design. Design practices and assumptions concerning limits of thermal movement, soil pressure, and pile design vary considerably among responding agencies. These decisions are based largely on past experience. Validity of these assumptions needs investigation by testing and analysis to ensure efficient and reliable design.

Uniform National Discharge Standards—Overview and Implications for Future Naval Engineering

AbstractIn the Fiscal Year 1996 National Defense Authorization Act, Congress amended the Clean Water Act to provide the Department of Defense and the Environmental Protection Agency authority to jointly establish standards for incidental discharges from Armed Forces' vessels. The uniform national standards would apply to discharges from vessels of the Navy, Military Sealift Command, Army, Marine Corps, Air Force, and Coast Guard to the navigable waters and contiguous zone of the U.S. and its territories.Uniform National Discharge Standards (UNDS) will require control of discharges, by either a technology or management practice. UNDS will facilitate the Armed Forces' ability to better design and build future vessels to be environmentally sound and to maintain the operational flexibility of Armed Forces' vessels both domestically and internationally. The development of standards for Armed Forces' vessel discharges may have greater impact on naval engineering requirements for future vessels than any other single environmental issue. These standards are expected to stimulate the development of innovative vessel pollution control technologies, which can be used for both Armed Forces' vessels and commercial shipping vessels. This paper provides an overview of UNDS development, summarizes the results of UNDS Phase I, provides a summary overview of the preliminary approach for accomplishing UNDS Phase II, and discusses implications for future naval engineering efforts.

Uniform National Discharge Standards—Overview and Implications for Future Naval Engineering

ABSTRACT In the Fiscal Year 1996 National Defense Authorization Act, Congress amended the Clean Water Act to provide the Department of Defense and the Environmental Protection Agency authority to jointly establish standards for incidental discharges from Armed Forces' vessels. The uniform national standards would apply to discharges from vessels of the Navy, Military Sealift Command, Army, Marine Corps, Air Force, and Coast Guard to the navigable waters and contiguous zone of the U.S. and its territories.Uniform National Discharge Standards (UNDS) will require control of discharges, by either a technology or management practice. UNDS will facilitate the Armed Forces' ability to better design and build future vessels to be environmentally sound and to maintain the operational flexibility of Armed Forces' vessels both domestically and internationally. The development of standards for Armed Forces' vessel discharges may have greater impact on naval engineering requirements for future vessels than any other single environmental issue. These standards are expected to stimulate the development of innovative vessel pollution control technologies, which can be used for both Armed Forces' vessels and commercial shipping vessels. This paper provides an overview of UNDS development, summarizes the results of UNDS Phase I, provides a summary overview of the preliminary approach for accomplishing UNDS Phase II, and discusses implications for future naval engineering efforts.

Juries and Crime Labs: Correcting the Weak Links in the DNA Chain

After a decade of courtroom battles and heated academic debate, the United States has entered an age where the scientific validity of deoxyribonucleic acid (DNA) evidence is not subject to serious dispute. The problem with DNA evidence is no longer one of validity, but one of proficiency. Two confounding variables in the DNA testing process weaken and often destroy DNA's powerfulness and usefulness in the courtroom: crime labs and juries.This Note proposes new and stringent standards for the admissibility of DNA evidence. The admissibility of forensic DNA evidence must be conditioned on its examination by a crime lab governed by uniform national standards. Such governing national standards must encompass every aspect of the forensic process, from chain of custody to DNA testing procedures, in order to ensure the reliability of DNA evidence. Implementing such a comprehensive national standard, however, only represents a first step toward solving the problem of DNA evidence in the courtroom. This step, however, fails to address the second problem facing the effective use of DNA in courtrooms: juries.

Toward protection of the marine environment: Uniform national discharge standards for military vessels

AbstractOn February 10, 1996, President Clinton signed into law a new mechanism for controlling discharges from military vessels. Section 325 of the 1996 Defense Authorization Act requires that Uniform National Discharge Standards(UNDS) be developed for vessels of the armed forces. The three primarily responsible agencies (Navy, Environmental Protection Agency (EPA), and Coast Guard) recently have undertaken a process to implement the new statute. Since the implementation process will determine the manner in which control of discharges from all U.S. military vessels will change over the next few years, it is a key activity in terms of protecting the quality of our marine environment. Information on the implementation process may assist state representatives, stakeholders and others in achieving more effective participation in it. The process also will guide major new environmental investments necessary to meet the evolving requirements and thus may be of interest to a variety of environmental contractors.

The politics of efficiencies, the efficiencies of politics: States vs. markets in environmental protection

In The Political Limits of Environmental Regulation: Tracking the Unicorn, Bruce Yandle identifies some of the key weaknesses of federal environmental regulation, including its regressive effects, its tendency to better serve selected political interests than the cause of environmental protection, and the EPA's failure to follow sensible priorities. Additional problems may also be cited, including the tendency to exclude citizens’ voices from deliberations regarding the degree of pollution control. But Yandle's conclusion regarding the likely superiority of decentralized and market‐sensitive alternatives to centralized regulation is overstated. Any such alternatives necessarily will continue to be grounded in relatively uniform national standards. Moreover, in the context of American political economy, market‐based controls would continue to deny many citizens real voice and choice. The quest continues to be for the combination of controls that best preserves both the environment and liberty.

The Political Impact of the Canadian Charter of Rights and Freedoms

AbstractThis article assesses the impact of the Charter of Rights and Freedoms on the Canadian political system. Unlike some commentators who have minimized the effect of the Charter, the author finds that the Charter is inducing significant and permanent changes in the conduct of Canadian politics. Canadian judges have shed their pre-Charter style of deference and self-restraint, and are playing a bolder and more influential role in the governing process. Charter decisions are remolding the Canadian criminal law process along the lines of the “due process” model and away from the “crime control” model of the pre-Charter era. The Charter has also begun to change the way the Canadian political system operates. Interest groups have responded by making greater use of Charter constitutional litigation as a tactic to pursue policy objectives. Law-making areas once solely the prerogative of provincial governments are now being threatened with uniform national standards laid down by the Supreme Court in the course of Charter decisions. Political executives are using the reference procedure to pass Charter issues on to the courts in order to avoid dealing with political “hot potatoes” such as abortion and minority language education. In sum, the predicted “judicialization of politics” is well under way.

Developing standards for environmental toxicants: the need to consider abiotic environmental factors and microbe-mediated ecologic processes.

This article suggests and discusses two novel aspects for the formulation of standards for environmental toxicants. First, uniform national standards for each pollutant will be underprotective for some ecosystems and overprotective for others, inasmuch as the toxicity of a pollutant to the indigenous biota is dependent on the physicochemical properties of the recipient environment. As the number of chemicals that need regulation is immense and as microbes appear to respond similarly to pollutant-abiotic factor interactions as do plants and animals, it is suggested that microbial assays be used initially to identify those abiotic factors that most influence the toxicity of specific pollutants. Thereafter, additional studies using plants and animals can focus on these pollutant-abiotic factor interactions, and more meaningful standards can then be formulated more rapidly and inexpensively. Second, it is suggested that the response to pollutants of microbe-mediated ecologic processes be used to quantitate the sensitivity of different ecosystems to various toxicants. Such a quantification, expressed in terms of an "ecological dose 50%" (EcD50), could be easily incorporated into the methodologies currently used to set water quality criteria and would also be applicable to setting criteria for terrestrial ecosystems.

VENDING SANITATION AND SAFETY-A CURRENT REPORT

While the automatic vending of food and beverages—and non-food merchandise—has been a part of The American scene since the late 1880's, problems of public health and safety did not enter the picture until the end of World War II when the first hot beverage vending machine went on location.In 1947, the vending industry and health officials first came together to discuss the development of uniform national standards for vending machines and vending operators. In 1957, after necessary research and preparation, The Public Health Service published The Vending of Food and Beverages—A Recommended Ordinance and Code. In the same year, the industry launched a full-time public health and safety program, guided by a nationally-constituted Health-Industry Council.The progress in sanitation and safety made as a result of cooperative industry and agency efforts over the past 12 years is discussed in terms of vending legislation, internal and external training, machine standardization and testing, and research.Concluding, a review of current problems in such matters as microwave safety, copper poisoning safeguards, temperature controls, icemaker design, and commissary layout is made, together with a “crystal ball” look at the future.