HIPAA

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Health Insurance Portability and Accountability Act (HIPAA)

Overview

The Health Insurance Portability and Accountability Act (HIPAA) was enacted by Congress on 21 August 1996 to combat waste, fraud and abuse, improve portability of health insurance coverage, and simplify health care administration. The Administrative Simplification provision, Title II, of HIPAA is vitally important to the health care industry as it includes provisions to promote efficient electronic transmission of health information, enhance patient rights, and provide standards to protect the privacy and security of health information.

The Administrative Simplification provision mandates the following regulations:

Privacy Standards – The Privacy standards provides the first comprehensive federal protection for the privacy of health information. This rule protects individually identifiable health information.
Transactions & Code Sets Standards – The Transactions & Code Sets standards establishes standard electronic transactions format and data content for submitting electronic claims and other administrative health transactions.
Security Standards –The security standards are designed to provide protection for all individually identifiable health information that is maintained, transmitted or received in electronic form.
Unique Identifiers – Eventually, HIPAA will require a unique identifying number for each provider, employer, health plan and individual.

HIPAA will result in industry-wide change in the way health care does business. Failure to comply will carry significant penalties, including possible monetary and criminal penalties.

See the Frequently Asked Questions or the HIPAA Glossary for more information about HIPAA and how WRNMMC is responding to these new requirements.