HITECH - National External Industry Outreach and Education for Implementation of HIPAA

HITECH - Recovery Act. THIS NOTICE IS FOR INFORMATIONAL PURPOSES ONLY. PLEASE DO NOT RESPOND.

The Congress addressed the need for a consistent framework for electronic health care transactions and other administrative simplification issues through the Health Insurance Portability and Accountability Act of 1996 (HIPAA), (Pub. L. 104 191) enacted on August 21, 1996. HIPAA requires the Secretary of HHS to adopt standards for certain electronic transactions to enable health information to be exchanged more efficiently and to achieve greater uniformity in the electronic transmission of health information.

Section 1104 of the Patient Protection and Affordable Care Act (Pub. L. 111 148) (hereinafter referred to as the Affordable Care Act or ACA) amended HIPAA (Part C-Administrative Simplification) by: adding electronic funds transfers (EFT) as a transaction for which the Secretary must adopt a standard; requiring adoption dates for a unique health plan identifier and the EFT and claims attachment standards; requiring adoption of a set of operating rules for each transaction; and mandating health plans to complete a certification of compliance process . The HIPAA Administrative Simplification provisions (and the administrative simplification provisions in the ACA that are not codified in the Social Security Act) are hereinafter referred to as Administrative Simplification (AS).

Since 2000, the Centers for Medicare & Medicaid Services' (CMS) has adopted transaction standards, standard identifiers, code sets and operating rules that implement HIPAA AS and its amendments.