Provider and Payor Relations

HIPAA

The Health Insurance Portability and Accountability Act passed in 1996. As you know HIPAA addresses a variety of confidentiality, privacy and security issues. The Centers for Medicare and Medicaid- CMS, under the Department of Health and Human Services, is responsible for implementing various provisions of HIPAA.

The most pressing issue at this time is the Administrative Simplification provision of HIPAA. This provision establishes national standards for electronic health care transactions and national identifiers for providers, health plans, and employers. Covered Entities, defined as “a health plan, a health care clearinghouse, or a health care provider who transmits any health information in electronic form in connection with a HIPAA transaction”.

For additional information please reference the CMS Security 101 document as well as other reference materials which can be found on the CMS website.

The following sources of information in addition to the CMS website should be helpful if you have additional questions: