What is HIPAA?

Overview

The Health Insurance Portability and Accountability Act of 1996 is an important law, passed by Congress, which is expected to have a major impact on every healthcare organization in the country.

Title II of HIPAA, the Administrative Simplification Compliance Act, is a major component of the HIPAA legislation. The Act instructs the Department of Health & Human Services to adopt standards for transactions that are conducted electronically between healthcare providers and insurers, and between insurers.

The four components of Administrative Simplification are:

  • Electronic Transactions
  • Privacy Standards
  • Code Sets & Unique Identifiers
  • Security Standards & Electronic Signature

The goal of these provisions is to simplify the administrative burden placed on healthcare providers. Addition HIPAA Policy goals include:

  • Protect the privacy of the patient by protecting their data
  • Focus healthcare providers with the importance of security and privacy
  • Create a common set of standards for securing such data, whether on paper or electronically
  • Improve efficiencies within the healthcare industry
  • Require efficiencies and security in the transfer of patient information

Specifically, the Department of Health and Human Services states in the Preamble to the Privacy Standards that the regulations are being instituted to:
1- Protect and enhance the rights of consumers
2 – Improve the quality of the healthcare system and restoring trust back in this system.
3- Improve the efficiency and effectiveness of healthcare delivery

HIPAA standards are being phased in over the course of several years.

Make Sure You Have the HIPAA Software to Comply with HIPAA Policy

The HIPAA compliance date was April 14, 2003 (April 14, 2004 for small health plans).

When choosing a vendor or HIPAA consultant to help you navigate the HIPAA policy, make sure you understand what that vendor is doing to help you bring your office up to standards. Make sure you know what type of HIPAA compliant medical billing software your HIPAA consultant is implementing to help you comply with HIPAA policy. This way you’ll have the HIPAA software to comply.

Medicare Enrollment Delays Leave Doctors Out in the Cold

A new centralized database implemented by the Centers for Medicare & Medicaid Services last November is creating problems for some clinicians participating in Medicare Part B who seek new enrollment applications or address changes. The system has been swamped with requests, often doubling the time it normally takes to process applications. Source: American Medical Association.

CMS Enrollment Regulation Elicits Physician Dread

In an effort to minimize CMS’s exposure to fraud, a proposed rule would require all physicians to re-enroll, including an estimated 300,000 doctors who were not required to complete the Medicare enrollment form that went into effect in 1996. Source: American Medical Association.

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