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HIPAA

The Administrative Simplification provision of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) was enacted Aug. 21, 1996. At varying levels, all health care organizations are affected by the Administrative Simplification provision of HIPAA. This includes all health care providers, all health plans, employers, public health entities, billing agencies, clearinghouses, information system vendors and others.

Specifically, the Administrative Simplification provision of HIPAA requires:

  • Standardization of electronic patient health, administrative and financial data (Transactions and code sets)
  • Unique identifiers for employers, health plans and health care providers (Identifiers)
  • Standards protecting the confidentiality (Privacy) and integrity of individually identifiable health information (Security)

Please visit the Health and Human Services Web site (external link) to read the regulations and receive answers to frequently asked questions.

National Provider Identifier (NPI)

The administrative simplification provisions of HIPAA require the Secretary of Health and Human Services (HHS) to adopt a national standard identifier for covered health care providers. The National Provider Identifier (NPI) will be the standard identifier and CMS is developing the National Plan and Provider Enumeration System (NPPES) to identify providers and assign NPIs.