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Health Insurance Portability & Accountability Act - Administrative Simplification
On August 21, 1996, President Clinton signed the Health Insurance Portability & Accountability Act (Kennedy - Kassebaum Bill) into law. Title II, Subtitle F is the portion that outlines Administrative Simplification (A.S.) is designed to make the health care industry more efficient by simplifying the administrative aspects and standardizing the electronic exchange of certain health information. The health care industry estimates that A.S. could save as much as $9 billion per year.
All health plans and clearinghouses and those providers who use electronic data interchange must meet these standards. That's right - not just the Medicare and Medicaid programs but all health plans. The provisions also require national standards for medical code sets; standard identifiers for providers, health plans, employers, and individuals; and security and privacy standards.
A wide range of organizations and individuals will be affected, including those that:
* Pay health care claims or coordinate benefits across payers.
* Submit claims to health plans.
* Submit medical encounter data to managed care plans.
* Enroll employees in health plans.
* Pay premiums to health plans.
* Conduct authorized referrals.
* Provide prior authorization for services.
* File first reports of injury for worker's compensation.
* Query insurance eligibility or claim status.
For More Information on HIPAA
DHHS Administrative Simplification
HHS Data Council
National Committee Health Vital Statistics (NCHVS)
HCFA Internet Security
Government Printing Office--Code of federal regulations
Workgroup for Electronic Data Interchange (WEDI)
Data Interchange Standards Association (DISA)
Association For Electronic Health Care Transactions (AFEHCT)
Washington Publishing Co--X12 Implementation Guides and training on EDI standards
Joint Healthcare Information Technology Alliance
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