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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
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Title I |
Focuses on the
goal of allowing persons to qualify immediately for comparable health
insurance coverage when they change their employment relationships. |
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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. |
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Title III |
Addresses
various issues, including medical savings, increases for health insurance
costs of self employed individuals, and long-term care services and
contracts. |
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Title IV |
Addresses
application and enforcement of group health plan requirements and
clarification of continuation of coverage requirements. |
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Title V
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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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