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What Is HIPAA?
The Health Insurance
Portability and Accountability Act of
1996, mandates standards for electronic data interchange (EDI) and code
sets, establishes uniform healthcare identifiers, and seeks protections
for the privacy and security of patient data.
In general, healthcare
organizations must comply with these standards within 26 months of the
publication of the final rules. Small health plans are granted an
additional 12 months to comply.
Compliance is required as
per the schedule below.
HIPAA Administrative
Simplification Compliance Deadlines
| Date |
Deadline |
| October 15, 2002 |
Deadline to submit a compliance extension
form for Electronic Health Care Transactions and Code Sets. |
| October 16, 2002 |
Electronic Health Care Transactions and
Code Sets - all covered entities except those who filed for an
extension and are not a small health plan. |
| April 14, 2003 |
Privacy - all covered entities except
small health plans. |
| April 16, 2003 |
Electronic Health Care Transactions and
Code Sets - all covered entities must have started software and
systems testing. |
| October 16, 2003 |
Electronic Health Care Transactions and
Code Sets - all covered entities who filed for an extension and
small health plans. |
| April 14, 2004 |
Privacy - small health plans. |
| July 30, 2004 |
Employer Identifier Standard - all covered
entities except small health plans. |
| August 1, 2005 |
Employer Identifier Standard - small
health plans. |
HIPAA has two objectives:
- To improve the
efficiency of healthcare delivery by standardizing the electronic
exchange of certain administrative and financial data; and
- To protect the security
and privacy of healthcare information.
HIPAA specifically calls
for the following:
- National universal
identifiers for patients, providers, health plans, and employers;
- Use of standard medical
and non-medical code sets in certain healthcare administrative and
financial EDI transactions;
- Protections for the
privacy and security of individually identifiable patient data;
- Penalties for the
violation of the data transmission and coding standards of HIPAA as
well as for the misuse of confidential patient data.
Penalties for misuse of
individually identifiable health information ("breach of
confidentiality" as it is sometimes called) will range from $50,000
up to 250,000 and/or imprisonment of up to 10 years, depending on the
severity and intent of the misuse.
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