HCCA - CHPC Overview

HIPAA became law - Answer- 1996 What is the purpose of HIPAA? - Answer- • To make health insurance portable under ERISA; • To move health care onto a nationally standardized electronic billing platform; and • To prevent fraud, waste and abuse Intent - Answer- purpose of this subtitle to improve the Medicare program under title XVIII of the Social Security Act, the Medicaid program under title XIX of such Act, and the efficiency and effectiveness of the health care system, by encouraging the development of a health information system through the establishment of standards and requirements for the electronic transmission of certain health information. HIPAA resides in what CFR section - Answer- 45 CFR sections 164.102 through 164.534 Identify the four sections in the CFR by location and topic - Answer- Section One: 164.102 - 164.318 and 164. Organizational Requirements Section Two: 164.500 - 164.514 Use and Disclosure of Information Section Three: 164.520 - 164.528 Individual's Rights and Penalties Section Four: Interaction with the HIPAA Security Rule How do you determine if organization is a CE - Answer- - compare the functions of the entity to the three principal types of "covered entities" (CE), - determine if the entity electronically transmits one of the nine defined transactions" What are the different types of CEs - Answer- - Provider - Health Plan - Clearing House - Other Types How is a Provider defined - Answer- - "a provider of services (as defined in section 1395x (u) of title XIX) - a provider of medical or other health services (as defined in section 1395x (s) of title XIX) - any other person furnishing health care services or supplies. Does a provider need a standing facility to be considered a CE - Answer- NO What does