HIPAA

• Important Information
• HIPAA Resources

What is HIPAA?

The Health Insurance Portability and Accountability Act was signed into law on August 21, 1996, to amend Title XI of the Social Security Act. The Act affects the entire healthcare industry, including providers, indemnity payors, health plans, clearinghouses, etc.

HIPAA was enacted to satisfy several purposes

• To improve the portability and continuity of health insurance coverage for groups and individuals
• To combat waste, fraud, and abuse in health insurance and healthcare delivery
• To promote the use of medical savings accounts
• To improve access to long-term care services and coverage
• To simplify the administration of health insurance

The goals of HIPAA Administrative Simplification are to

• Improve the efficiency and effectiveness of the health care system
• Standardize the electronic data interchange of administrative transactions
• Protect the security and privacy of protected health information (both electronic and paper)

Regulations will affect all organizations in the health care system

• Health Plans
• Health Care Clearinghouses
• Health Care Providers
• Business Associates of above

HIPAA Regulations

Electronic Transactions and Code Sets

Use of standardized electronic transaction formats for each of eight health care transactions types and use of standardized code sets for identification of items submitted on health care claims (e.g. medical diagnoses and procedures).

Privacy of Protected Individually Identifiable Health Information

Confidentiality guidelines for information transmitted or stored in any medium that describes an individual's health status and identifies or could be used to identify an individual

Security Standards

Procedures and practices to safeguard protected health information collected, transmitted, or stored electronically by health plans, health care providers, or health care clearinghouses.

National Provider Identifier

Unique identifier system allowing providers to use one unique identification number for all transactions with all health plans.

National Employer Identifier

Unique identifier for employer sponsored health programs.