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Health Insurance Portability and Accountability Act of 1996
Work was being done in the mid 1990s to reform health care. The focus was on providing greater access to health care and addressing administrative concerns. In 1996, the Health Insurance Portability and Accountability Act ( HIPAA ) was enacted into law. The law contains a section known as Administrative Simplification provisions that require HHS to adopt national standards for: Electronic transactions and code set; standards Privacy; standards for Security; and National identifiers. It was modified in 2009 by ARRA/HITECH and on January 23, 2013, HHS announced the final Omnibus Rule further modifying the HIPAA Privacy, Security, and Enforcement. Compliance by Business Associates and Covered Entities became effective September 23, 2013.
Who Must Know and Abide by HIPAA Rules?
Covered Entities (CE) must be in compliance. CEs are any organizations or corporations that directly handles protected health information (PHI) or personal health records (PHR) including: Health Care Providers (doctors, clinics, psychologists, dentists, chiropractors, nursing homes, pharmacies); Health Plans (health insurance companies, HMOs, company health plans, government programs that pay for health care); and Health Care Clearinghouse (entities that process nonstandard health information they receive from another entity into a standard electronic format or data content).
Business Associates (BA) must be in compliance. BAs are third party administrator who assists a health plan with claims processing; Patient Safety Organizations and others involved in patient safety activities; Health Information Organizations (e-prescribing gateways or health information exchanges that transmit and maintain PHI and personal health record vendors physicians sponsor for their patients; pharmacy benefits manager; independent medical transcriptionist; Consultant who provides utilization reviews; attorney whose legal services to a health plan involve access to PHI; subcontractors that create, receive, maintain, or transmit PHI on behalf of BAs; or anyone that works with a covered entity that may have access to protected health information.
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