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HIPAA - Health Insurance Portability and Accountability Act of 1996
The Health Insurance Portability and Accountability Act (HIPAA) was signed into law in 1996, in part, as a response to concerns regarding confidential health information. HIPAA's overall purpose is to:
- Provide continuity and portability of health benefits to people in between jobs
- Ensure security and privacy of individual health information
- Reduce administrative expenses in the healthcare system; administrative costs have been estimated to account for nearly 25% of healthcare costs
- Provide uniform standards for electronic health information transactions
- Provide measures to combat fraud and abuse in health insurance and health care delivery
Overview of HIPAA Law/Rules
| Title I |
Focuses on the goal of allowing persons to qualify immediately for comparable health insurance coverage when they change their employment relationships |
| Title II |
Goal of reducing the costs and administrative burdens of health care by replacing the many non-standard formats currently used nationally, with a single set of electronic standards to be used nationally, with a single set of electronic standards that would be used throughout the healthcare industry |
| Title III |
Addresses various issues, including medical savings, increases for health insurance costs of self employed individuals, and long-term care services and contracts |
| Title IV |
Addresses application and enforcement of group health plan requirements and clarification of continuation of coverage requirements |
| Title V |
Addresses various issues, including company owned life insurance and treatment of individuals who lose US citizenship |
Title II, subtitle F, known as the Administrative Simplification Act, has the greatest impact on health care providers. It identifies standards for the following key areas:
- Electronic Data Interchange (EDI) for Claims/Transaction Administration
- National Unique Identifiers
- Standardized Code Sets
- Security
- Electronic Signatures
- Transfer of Information among Health Plans
- Privacy
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