HIPAA Compliancy - PracticeAdmin


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HIPAA Compliancy

The Health Insurance Portability and Accountability Act (HIPAA) became law in 1996, and the Administrative Simplification provisions of the act are having the most impact on the healthcare environment. These require the Secretary of Health and Human Services (HHS) to adopt standards and data elements for electronic transactions; unique health identifiers for individuals, employers, health plans, and health care providers; and security standards and safeguards for electronic information systems involved in those transactions. The Secretary is also responsible for standards for ensuring the privacy of electronic transactions.

One of the changes which is still rumbling through the EDI landscape was the mandatory change to the ANSI standard for claim and claim related electronic files. PA medical practice management software utilizes the code sets mandated by HIPAA for electronic claims submission and other claim related transactions - there is no mapping from older versions of claim file formats to the newer ANSI standard formats, and thus less is lost in translation.

The Centers for Medicare & Medicaid Services (CMS) is responsible for implementing various unrelated provisions of HIPAA, therefore HIPAA compliance may mean different things to different people. For further details about this, visit the CMS website. For your convenience, we have copies of the three U.S. Department of Health and Human Services (DHHS) rules for viewing or downloading. Each of these require Adobe Acrobat Reader - use the link at the bottom of the page to get the free reader if you do not have it.

45 CFR Parts 160 and 162 Health Insurance Reform: Standards for Electronic Transactions; Announcement of Designated Standard Maintenance Organizations; Final Rule and Notice

45 CFR Parts 160 and 164 Standards for Privacy of Individually Identifiable Health Information; Final Rule

45 CFR Part 142 Security and Electronic Signature Standards; Final Rule

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