HIPAA stands for the Health Insurance Portability and Accountability Act, also known as Kennedy-Kassebaum Act, which was signed into law August 21, 1996. The section of the act which we are making you aware of is subtitle F- Administrative Simplification.
The purpose of the legislation is to improve the efficiency and effectiveness of the health care system by standardizing the electronic exchange of administrative and financial data; and to protect the security and privacy of transmitted information. In other words, you will no longer have to worry about what format information is submitted to each insurance plan because they will all be standard. The law also includes provisions for unique identification numbers for all providers, patients, payers, and employers. Code sets will also be standardized along with provisions for security and privacy of identifiable health information.
The standards being mandated are:
On August 17, 2000 the final rule was published which requires ANSI version 4010a1 electronic formats for the specified electronic healthcare transactions and the above mentioned HIPAA Medical code sets be adopted within 26 months (of date the final regulations are published in the Federal Register). "Small" health plans will be allotted 36 months. Health Plans were given a one-year extension and on October 16, 2003 BCNEPA became compliant with the HIPAA code set and transaction standards.
Providers can also choose to utilize a clearinghouse to translate their electronic transactions into standard formats, if they are not capable of complying with the standards. Non-compliance with provisions of the Act will result in significant financial penalties.
The following is the schedule for which the Department of Health and Human Services (DHHS) is planning to issue HIPAA regulations.
| NPRMs Already Published | |||
| Standard | NPRM Published | Final Rule Publication | Date Compliance Required |
| Transactions and Code Sets | 5/7/1998 | 8/17/2000 | 10/16/2002 |
| National Provider Identifier | 5/7/1998 | 1/23/2004 | 5/23/2007 |
| National Employer Identifier | 6/16/1998 | 5/31/2002 | 6/30/2004 |
| Security | 8/12/1998 | 8/12/1998 | 4/20/2005 |
| Privacy | 11/3/1999 | 12/28/2000 | 4/14/2003 |
| NPRMs in Development | |||
| Standard | Expected NPRM Publication | Expected Final Rule Publication | Expected Date Compliance Required |
| National Health Plan Identifier | Fall 2005 | ||
| Claims Attachments | Summer 2005 | ||
| National Individual Identifier | ON HOLD | ||
| *Standards are required to be implemented within 2 years of the effective date of the final rule. (The effective date of the final rule is generally 60 days after its publication,) | |||
If you would like additional information on HIPAA, noted below are Web sites you may want to consult.