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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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