HIPAA

The Health Insurance Portability and Accountability Act (HIPAA) was signed into law on Aug. 21, 1996, under the administrative simplification provisions of Title XI of the Social Security Act. The act affects the entire health care industry, including providers, indemnity payers, health plans and clearinghouses.

HIPAA gives individuals control over how their health information is used, and defines the circumstances under which it can be disclosed.

HIPAA was enacted to satisfy several purposes:

• To improve the portability and continuity of health insurance coverage for groups and individuals 
• To combat waste, fraud, and abuse in health insurance and health care delivery 
• To promote the use of medical savings accounts 
• To improve access to long-term care services and coverage 
• To simplify the administration of health insurance

The goals of HIPAA Administrative Simplification are to:

• Improve the efficiency and effectiveness of the health care system 
• Standardize the electronic data interchange of administrative transactions 
• Protect the security and privacy of protected health information (both electronic and paper)

HIPAA includes several key areas or parts:

• Privacy
• Transactions and Code Sets 
• Security
• National Provider Identifier
• National Employer Identifier

HIPAA Resources

• Denial codes (PDF)
• Medicaid HIPAA administrative simplification
• Administrative simplification
• U.S. HHS Office of Civil Rights HIPAA privacy rule FAQ

For help or questions about HIPAA, call First Choice Provider Services at 1-800-741-6605.