Emily MarshallHIPAA

HIPAA Tittle II

One of the primary areas of regulation is standardization of health care transactions. Covered entities must be compliant with electronic transactions requirements by October 2002 (October 2003 if the covered entity has requested a one-year extension from the government or if the covered entity is a small health plan). HIPAA requires every provider who does business electronically to use the same health care transactions, code sets, and identifiers. Anthem has filed for, and received, a one-year extension for compliance with the electronic transactions requirements. Covered entities must be complaint with unique identifiers rules is published. Unique identifiers rule has three unique identifiers: Standard unique employer identifier used on an organization’s federal IRS Form W-2. This identifies an employer entity in HIPAA transactions. Another one is National provider identifier (NPI) which is a unique 10-digit number used for covered health-care providers in all HIPAA administrative and financial transactions. The last but not least is national Health plan identifier (NHI), it is a centers of Medicare and Medicaid services (CMS) proposed identifier to identify health plan and payers.

The second primary controls to protect health information regulations like your privacy rule and security rule. The major goal of the Privacy Rule is to assure that individuals’ health information is properly protected while allowing the flow of health information needed to provide and promote high quality health care and to protect the public’s health and well-being. The Rule strikes a balance that permits important uses of information, while protecting the privacy of people who seek care and healing. The security rule means that e-PHI is not available or disclosed to unauthorized persons. The security rule’s confidentiality requirements support the privacy rule’s prohibitions against improper uses and disclosures of PHI. The security rule also promotes the two additional goals of maintaining the integrity and availability of e-PHI. Under the security rule, “integrity” means that e-PHI is not altered or destroyed in an unauthorized manner. “Availability” means that e-PHI is accessible and usable on demand by an authorized person.

http://www.hhs.gov/hipaa/for-professionals/security/laws-regulations/

http://www.hhs.gov/sites/default/files/privacysummary.pdf

https://www.anthem.com/shared/noapplication/f3/s1/t0/pw_035866.pdf

https://www.cms.gov/Regulations-and-Guidance/HIPAA-Administrative-Simplification/EventsandLatestNews/Downloads/HIPAA101-1.pdf