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Department Of Health And Human Services

The Health Insurance Portability and Accountability Act (HIPAA) was made a law on 21 August 1996. HIPAA is still the law with jurisdiction over privacy and security of personal health information (PHI) and governing authority for the electronic transactions, even after twenty years. However, many changes have taken place in these twenty years. This period has seen the rise of internet, smartphones, emails, EHRs, and much other advancement that have changed our day-to-day lives critically.

Much emphasis has been placed on privacy and security provisions of the law that has resulted in millions of dollars in financial settlements to health systems for breaches in privacy and other violations that are related to protection of personal health information. The Department of Health and Human Services (HHS) Office of Civil Rights (OCR) has put forward corrective actions and financial solutions for these violations.

HIPAA Covered Entities have reacted to regulatory attention on security and privacy by investing resources to protect their IT systems. Sadly, one cannot see similar commitment of resources to other sections of HIPAA. Yet, the level of ignoring is significant with respect to this provision among industry.

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Personal Health Information

An argument can be made regarding the business component of health system being administratively simple that it was twenty years ago, but the industry does not acknowledge that the system is administratively simple. It is true that the standard business transactions have led to improved efficiency in information transfer but there is still much to be done to have a simple electronic information exchange system.

The above-mentioned improvements need to be translated to the healthcare system, especially for the HIPAA standard transactions. For instance, healthcare providers are waiting for all the plans to accept batch requests for insurance enrollment eligibility. Even existing transactions are also continuing to pose problems to HBMA members.

CMS has recently made some moves to better promote administrative simplification provisions by updating their webpage. Also, the works done by groups like CAQH CORE, National Committee on Vital and Health Statistics (NCVHS), and X12 have led to some welcome improvements.

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