Agenda - 09-17-2002 - 8g - Laserfiche WebLink

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4 Background Repbrt Health Insurance Portability and Accountability Act of 1996 (HIPAA) Congress passed the Health Insurance Portability and Accountability Act of 1996 (HIPAA) in response to requests for standardization of the electronic health care payment process. HIPAA was meant primarily to protect the health insurance rights of workers who changed jobs and to provide enhanced enforcement of health insurance fraud-and-abuse laws. HIPAA also included, however, "Administrative Simplification" standards that directed the U.S. Department of Health and Human Services (DHHS) to publish regulations concerning the interchange and protection of health information data. The federal DHHS has already issued three sets of regulations in final form (e.g., transactions and code sets, provider identifiers and privacy rules) and others (e.g., security rules) are in process. The Administrative Simplification regulations, finalized so far, include the following: • Electronic Data Interchange (EDI)—The Health care industry uses many different electronic formats and codes to exchange health information for billing and other purposes related to payment. The goal of the HIPAA provisions are to standardize the form and codes involved in these electronic transactions and thereby decrease the administrative costs of health care billing. The regulation includes, for example, uniform codes for diagnoses or medical procedures that are used to transmit health information. County Departments that electronically bill for medical services must come into compliance with this portion of the regulations or submit a plan for compliance by October 16, 2002. The compliance plan may be submitted by the "Covered Entity", as defined below, by filling out a "Model Compliance Plan" consisting of a fairly routine intemet-based (online) questionnaire form (attached to this report). • Privacy Rules—The privacy regulations provide a comprehensive set of rules for the use and disclosure of patient identifying health information and establish new patient rights with respect to Protected Health Information (PHI), including new disclosure authorization, consent and notice rights. Covered entities must comply with their requirements by April 14, 2003. See the next page for a chart that details the initial timeline on achieving compliance with the current regulations.