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.
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