Health Insurance Portability and Accountability Act

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NPI by May 23, 2008. Effective from May 2006 (May 2007 for small health plans), all covered entities using electronic communications (e.g., physicians, hospitals, health insurance companies, and so forth) must use a single new NPI. The NPI replaces all other identifiers used by health plans, Medicare, Medicaid, and other government programs. However, the NPI does not replace a provider's DEA number, state license number, or tax identification number. The NPI is 10 digits (may be alphanumeric), with the last digit being a checksum. The NPI cannot contain any embedded intelligence; in other words, the NPI is simply a number that does not itself have any additional meaning. The NPI is unique and national, never re-used, and except for institutions, a provider usually can have only one. An institution may obtain multiple NPIs for different "sub-parts" such as a free-standing cancer center or rehab facility.

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Information (EPHI). It lays out three types of security safeguards required for compliance: administrative, physical, and technical. For each of these types, the Rule identifies various security standards, and for each standard, it names both required and addressable implementation specifications. Required specifications must be adopted and administered as dictated by the Rule. Addressable specifications are more flexible. Individual covered entities can evaluate their own situation and determine the best way to implement addressable specifications. Some privacy advocates have argued that this "flexibility" may provide too much latitude to covered entities. Software tools have been developed to assist covered entities in the risk analysis and remediation tracking. The standards and specifications are as follows:

885:(HHS) has investigated over 19,306 cases that have been resolved by requiring changes in privacy practice or by corrective action. If noncompliance is determined by HHS, entities must apply corrective measures. Complaints have been investigated against many different types of businesses such as national pharmacy chains, major health care centers, insurance groups, hospital chains and other small providers. There were 9,146 cases where the HHS investigation found that HIPAA was followed correctly. There were 44,118 cases that HHS did not find eligible cause for enforcement; for example, a violation that started before HIPAA started; cases withdrawn by the pursuer; or an activity that does not actually violate the Rules. 649:(837) is used to submit health care claim billing information, encounter information, or both, except for retail pharmacy claims (see EDI Retail Pharmacy Claim Transaction). It can be sent from providers of health care services to payers, either directly or via intermediary billers and claims clearinghouses. It can also be used to transmit health care claims and billing payment information between payers with different payment responsibilities where coordination of benefits is required or between payers and regulatory agencies to monitor the rendering, billing, and/or payment of health care services within a specific health care/insurance industry segment. 45: 317:. It generally prohibits healthcare providers and businesses called covered entities from disclosing protected information to anyone other than a patient and the patient's authorized representatives without their consent. The bill does not restrict patients from receiving information about themselves (with limited exceptions). Furthermore, it does not prohibit patients from voluntarily sharing their health information however they choose, nor does it require confidentiality where a patient discloses medical information to family members, friends or other individuals not employees of a covered entity. 730:(997) is a transaction set that can be used to define the control structures for a set of acknowledgments to indicate the results of the syntactical analysis of the electronically encoded documents. Although it's not specifically named in the HIPAA Legislation or Final Rule, it's necessary for X12 transaction set processing. The encoded documents are the transaction sets, which are grouped in functional groups, used in defining transactions for business data interchange. This standard doesn't cover the semantic meaning of the information encoded in the transaction sets. 718:(277) is a transaction set that can be used by a healthcare payer or authorized agent to notify a provider, recipient or authorized agent regarding the status of a health care claim or encounter, or to request additional information from the provider regarding a health care claim or encounter. This transaction set is not intended to replace the Health Care Claim Payment/Advice Transaction Set (835) and therefore, is not used for account payment posting. The notification is at a summary or service line detail level. The notification may be solicited or unsolicited. 378:

the beneficiary may be counted with 18 months of general coverage, but only 6 months of dental coverage, because the beneficiary did not have a general health plan that covered dental until 6 months prior to the application date). Since limited-coverage plans are exempt from HIPAA requirements, the odd case exists in which the applicant to a general group health plan cannot obtain certificates of creditable continuous coverage for independent limited-scope plans, such as dental to apply towards exclusion periods of the new plan that does include those coverages.

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case of late enrollment. Title I allows individuals to reduce the exclusion period by the amount of time that they have had "creditable coverage" before enrolling in the plan and after any "significant breaks" in coverage. "Creditable coverage" is defined quite broadly and includes nearly all group and individual health plans, Medicare, and Medicaid. A "significant break" in coverage is defined as any 63-day period without any creditable coverage. Along with an exception, it allows employers to tie premiums or co-payments to tobacco use, or body mass index.

614:, said that some hospitals are being "overcautious" and misapplying the law, the Times reports. Suburban Hospital in Bethesda, Md., has interpreted a federal regulation that requires hospitals to allow patients to opt out of being included in the hospital directory as meaning that patients want to be kept out of the directory unless they specifically say otherwise. As a result, if a patient is unconscious or otherwise unable to choose to be included in the directory, relatives and friends might not be able to find them, Goldman said. 586:

messaging (a secure email technology in common use in the healthcare industry), or possibly other methods. When using unencrypted email, the individual must understand and accept the risks to privacy using this technology (the information may be intercepted and examined by others). Regardless of delivery technology, a provider must continue to fully secure the PHI while in their system and can deny the delivery method if it poses additional risk to PHI while in their system.

684:(834) can be used by employers, unions, government agencies, associations or insurance agencies to enroll members to a payer. The payer is a healthcare organization that pays claims, administers insurance or benefit or product. Examples of payers include an insurance company, healthcare professional (HMO), preferred provider organization (PPO), government agency (Medicaid, Medicare etc.) or any organization that may be contracted by one of these former groups. 1220:(D-MA) came together and created a bill called the Health Insurance Reform Act of 1995 or more commonly known as the Kassebaum-Kennedy Bill. This bill was stalled despite making it out of the Senate. In the 1996 State of the Union address, Clinton pressed the issue, and it resulted in bipartisan cooperation. After much debate and negotiation, there was a shift in momentum once a compromise between Kennedy and 396: 630:) provision was scheduled to take effect from October 16, 2003, with a one-year extension for certain "small plans". However, due to widespread confusion and difficulty in implementing the rule, Centers for Medicare & Medicaid Services (CMS) granted a one-year extension to all parties. On January 1, 2012, newer versions, 509:

yet taken any enforcement actions against hospitals, doctors, insurers or anyone else for rule violations. A spokesman for the agency says it has closed three-quarters of the complaints, typically because it found no violation or after it provided informal guidance to the parties involved." However, in July 2011, the

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Title V includes provisions related to company-owned life insurance for employers providing company-owned life insurance premiums, prohibiting the tax-deduction of interest on life insurance loans, company endowments, or contracts related to the company. It also repeals the financial institution rule

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This may have changed with the fining of $ 50,000 to the Hospice of North Idaho (HONI) as the first entity to be fined for a potential HIPAA Security Rule breach affecting fewer than 500 people. Rachel Seeger, a spokeswoman for HHS, stated, "HONI did not conduct an accurate and thorough risk analysis

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Documented risk analysis and risk management programs are required. Covered entities must carefully consider the risks of their operations as they implement systems to comply with the act. (The requirement of risk analysis and risk management implies that the act's security requirements are a minimum

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For example, a state mental health agency may mandate all healthcare claims, Providers and health plans who trade professional (medical) health care claims electronically must use the 837 Health Care Claim: Professional standard to send in claims. As there are many different business applications for

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Under HIPAA, HIPAA-covered health plans are now required to use standardized HIPAA electronic transactions. See, 42 USC § 1320d-2 and 45 CFR Part 162. Information about this can be found in the final rule for HIPAA electronic transaction standards (74 Fed. Reg. 3296, published in the Federal Register

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The Privacy Rule requires covered entities to notify individuals of uses of their PHI. Covered entities must also keep track of disclosures of PHI and document privacy policies and procedures. They must appoint a Privacy Official and a contact person responsible for receiving complaints and train all

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On February 16, 2006, HHS issued the Final Rule regarding HIPAA enforcement. It became effective on March 16, 2006. The Enforcement Rule sets civil money penalties for violating HIPAA rules and establishes procedures for investigations and hearings for HIPAA violations. For many years there were few

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Covered entities that out-source some of their business processes to a third party must ensure that their vendors also have a framework in place to comply with HIPAA requirements. Companies typically gain this assurance through clauses in the contracts stating that the vendor will meet the same data

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using the "view, download, and transfer" feature which is required for certification. When delivered to the individual in electronic form, the individual may authorize delivery using either encrypted or unencrypted email, delivery using media (USB drive, CD, etc., which may involve a charge), direct

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Individuals have the broad right to access their health-related information, including medical records, notes, images, lab results, and insurance and billing information. Explicitly excluded are the private psychotherapy notes of a provider, and information gathered by a provider to defend against a

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It is a misconception that the Privacy Rule creates a right for any individual to refuse to disclose any health information (such as chronic conditions or immunization records) if requested by an employer or business. HIPAA Privacy Rule requirements merely place restrictions on disclosure by covered

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A covered entity may disclose PHI to certain parties to facilitate treatment, payment, or health care operations without a patient's express written authorization. Any other disclosures of PHI require the covered entity to obtain written authorization from the individual for disclosure. In any case,

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Some health care plans are exempted from Title I requirements, such as long-term health plans and limited-scope plans like dental or vision plans offered separately from the general health plan. However, if such benefits are part of the general health plan, then HIPAA still applies to such benefits.

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Title I of HIPAA regulates the availability and breadth of group health plans and certain individual health insurance policies. It amended the Employee Retirement Income Security Act, the Public Health Service Act, and the Internal Revenue Code. Furthermore, Title I addresses the issue of "job lock"

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HIPAA covered entities such as providers completing electronic transactions, healthcare clearinghouses, and large health plans must use only the National Provider Identifier (NPI) to identify covered healthcare providers in standard transactions by May 23, 2007. Small health plans must use only the

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In addition, the definition of "significant harm" to an individual in the analysis of a breach was updated to provide more scrutiny to covered entities with the intent of disclosing breaches that previously were unreported. Previously, an organization needed proof that harm had occurred whereas now

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agreed to pay $ 865,500 in a settlement regarding potential HIPAA violations. An HHS Office for Civil Rights investigation showed that from 2005 to 2008, unauthorized employees repeatedly and without legitimate cause looked at the electronic protected health information of numerous UCLAHS patients.

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The Privacy Rule came into effect on April 14, 2003, with a one-year extension for certain "small plans". By regulation, the HHS extended the HIPAA privacy rule to independent contractors of covered entities who fit within the definition of "business associates". PHI is any information that is held

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An alternate method of calculating creditable continuous coverage is available to the health plan under Title I. That is, 5 categories of health coverage can be considered separately, including dental and vision coverage. Anything not under those 5 categories must use the general calculation (e.g.,

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An Act To amend the Internal Revenue Code of 1986 to improve portability and continuity of health insurance coverage in the group and individual markets, to combat waste, fraud, and abuse in health insurance and health care delivery, to promote the use of medical savings accounts, to improve access

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The enactment of the Privacy and Security Rules has caused major changes in the way physicians and medical centers operate. The complex legalities and potentially stiff penalties associated with HIPAA, as well as the increase in paperwork and the cost of its implementation, were causes for concern

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HIPAA was intended to make the health care system in the United States more efficient by standardizing health care transactions. HIPAA added a new Part C titled "Administrative Simplification" to Title XI of the Social Security Act. This is supposed to simplify healthcare transactions by requiring

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In January 2013, HIPAA was updated via the Final Omnibus Rule. The updates included changes to the Security Rule and Breach Notification portions of the HITECH Act. The most significant changes related to the expansion of requirements to include business associates, where only covered entities had

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reported that the OCR had a long backlog and ignores most complaints. "Complaints of privacy violations have been piling up at the Department of Health and Human Services. Between April of 2003 and November 2006, the agency fielded 23,886 complaints related to medical-privacy rules, but it has not

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The Privacy Rule gives individuals the right to request a covered entity to correct any inaccurate PHI. Also, it requires covered entities to take some reasonable steps on ensuring the confidentiality of communications with individuals. For example, an individual can ask to be called at their work

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Hidden exclusion periods are not valid under Title I (e.g., "The accident, to be covered, must have occurred while the beneficiary was covered under this exact same health insurance contract"). Such clauses must not be acted upon by the health plan. Also, they must be re-written so they can comply

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Title I requires the coverage of and also limits restrictions that a group health plan can place on benefits for preexisting conditions. Group health plans may refuse to provide benefits in relation to preexisting conditions for either 12 months following enrollment in the plan or 18 months in the

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The largest fines of $ 5.5 million levied against Memorial Healthcare Systems in 2017 for accessing confidential information of 115,143 patients and of $ 4.3 million levied against Cignet Health of Maryland in 2010 for ignoring patients' requests to obtain copies of their own records and repeated

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The complexity of HIPAA, combined with potentially stiff penalties for violators, can lead physicians and medical centers to withhold information from those who may have a right to it. A review of the implementation of the HIPAA Privacy Rule by the U.S. Government Accountability Office found that

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Covered entities may disclose protected health information to law enforcement officials for law enforcement purposes as required by law (including court orders, court-ordered warrants, subpoenas) and administrative requests; or to identify or locate a suspect, a fugitive, a material witness, or a

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is used to submit retail pharmacy claims to payers by health care professionals who dispense medications, either directly or via intermediary billers and claims clearinghouses. It can also be used to transmit claims for retail pharmacy services and billing payment information between payers with

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Title II of HIPAA establishes policies and procedures for maintaining the privacy and the security of individually identifiable health information, outlines numerous offenses relating to health care, and establishes civil and criminal penalties for violations. It also creates several programs to

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According to the US Department of Health and Human Services Office for Civil Rights, between April 2003 and January 2013, it received 91,000 complaints of HIPAA violations, in which 22,000 led to enforcement actions of varying kinds (from settlements to fines) and 521 led to referrals to the US

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The Privacy Rule requires medical providers to give individuals access to their PHI. After an individual requests information in writing (typically using the provider's form for this purpose), a provider has up to 30 days to provide a copy of the information to the individual. An individual may

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These rules apply to "covered entities", as defined by HIPAA and the HHS. Covered entities include health plans, health care clearinghouses (such as billing services and community health information systems), and health care providers that transmit health care data in a way regulated by HIPAA.

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The Final Rule on Security Standards was issued on February 20, 2003. The Security Rule complements the Privacy Rule. While the Privacy Rule pertains to all Protected Health Information (PHI) including paper and electronic, the Security Rule deals specifically with Electronic Protected Health

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An individual may also request (in writing) that the provider send PHI to a designated service used to collect or manage their records, such as a Personal Health Record application. For example, a patient can request in writing that her ob-gyn provider digitally transmit records of her latest

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Title I mandates that insurance providers must issue policies without exclusions to individuals leaving group health plans, provided they have maintained continuous, credible coverage. (see above) exceeding 18 months, and renew individual policies for as long as they are offered or provide

724:(278) is a transaction set that can be used to transmit health care service information, such as subscriber, patient, demographic, diagnosis or treatment data for the purpose of the request for review, certification, notification or reporting the outcome of a health care services review. 1095:

The first criminal indictment was lodged in 2011 against a Virginia physician who shared information with a patient's employer "under the false pretenses that the patient was a serious and imminent threat to the safety of the public, when in fact he knew that the patient was not such a

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San Francisco crash, some hospitals were reluctant to disclose the identities of passengers that they were treating, making it difficult for Asiana and the relatives to locate them. In one instance, a man in Washington state was unable to obtain information about his injured mother.

574:) system that is certified using CEHRT (Certified Electronic Health Record Technology) criteria, individuals must be allowed to obtain the PHI in electronic form. Providers are encouraged to provide the information expediently, especially in the case of electronic record requests. 789:

A contingency plan should be in place for responding to emergencies. Covered entities are responsible for backing up their data and having disaster recovery procedures in place. The plan should document data priority and failure analysis, testing activities, and change control

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Internal audits play a key role in HIPAA compliance by reviewing operations with the goal of identifying potential security violations. Policies and procedures should specifically document the scope, frequency, and procedures of audits. Audits should be both routine and

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Covered entities must also authenticate entities with which they communicate. Authentication consists of corroborating that an entity is who it claims to be. Examples of corroboration include password systems, two or three-way handshakes, telephone callback, and token

965:. Another study, detailing the effects of HIPAA on recruitment for a study on cancer prevention, demonstrated that HIPAA-mandated changes led to a 73% decrease in patient accrual, a tripling of time spent recruiting patients, and a tripling of mean recruitment costs. 1004:

In the period immediately before the enactment of the HIPAA Privacy and Security Acts, medical centers and medical practices were charged with complying with the new requirements. Many practices and centers turned to private consultants for compliance assistance.

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health care providers were "uncertain about their legal privacy responsibilities and often responded with an overly guarded approach to disclosing information ... than necessary to ensure compliance with the Privacy rule". Reports of this uncertainty continue.

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Information systems housing PHI must be protected from intrusion. When information flows over open networks, some form of encryption must be utilized. If closed systems/networks are utilized, existing access controls are considered sufficient and encryption is

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In addition to policies and procedures and access records, information technology documentation should also include a written record of all configuration settings on the components of the network because these components are complex, configurable, and always

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different payment responsibilities where coordination of benefits is required or between payers and regulatory agencies to monitor the rendering, billing, and/or payment of retail pharmacy services within the pharmacy health care/insurance industry segment.

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Technical Safeguards – controlling access to computer systems and enabling covered entities to protect communications containing PHI transmitted electronically over open networks from being intercepted by anyone other than the intended recipient.

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which is the inability for an employee to leave their job because they would lose their health coverage. To combat the job lock issue, the Title protects health insurance coverage for workers and their families if they lose or change their jobs.

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Per the requirements of Title II, the HHS has promulgated five rules regarding Administrative Simplification: the Privacy Rule, the Transactions and Code Sets Rule, the Security Rule, the Unique Identifiers Rule, and the Enforcement Rule.

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to the confidentiality of ePHI as part of its security management process from 2005 through Jan. 17, 2012." This investigation was initiated with the theft from an employees vehicle of an unencrypted laptop containing 441 patient records.

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Procedures should clearly identify employees or classes of employees who have access to electronic protected health information (EPHI). Access to EPHI must be restricted to only those employees who have a need for it to complete their job

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protection requirements that apply to the covered entity. Care must be taken to determine if the vendor further out-sources any data handling functions to other vendors and monitor whether appropriate contracts and controls are in place.

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was accepted, after alterations were made of the original Kassebaum-Kennedy Bill. Soon after this, the bill was signed into law by President Clinton and was named the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

473:(PHI) in healthcare treatment, payment and operations by "covered entities" (generally, health care clearinghouses, employer-sponsored health plans, health insurers, and medical service providers that engage in certain transactions). 905:

Title IV specifies conditions for group health plans regarding coverage of persons with preexisting conditions, and modifies continuation of coverage requirements. It also clarifies continuation coverage requirements and includes

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entities and their business associates without the consent of the individual whose records are being requested; they do not place any restrictions upon requesting health information directly from the subject of that information.

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In 1994, President Clinton expressed his goals to improve the healthcare system. However, his reforms did not succeed, most likely due to lack of support. The Congressional Quarterly Almanac of 1996 explains how two senators,

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Covered entities (entities that must comply with HIPAA requirements) must adopt a written set of privacy procedures and designate a privacy officer to be responsible for developing and implementing all required policies and

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HIPAA restrictions on researchers have affected their ability to perform retrospective, chart-based research as well as their ability to prospectively evaluate patients by contacting them for follow-up. A study from the

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Armstrong D, Kline-Rogers E, Jani S, Goldman E, Fang J, Mukherjee D, Nallamothu B, Eagle K (2005). "Potential impact of the HIPAA privacy rule on data collection in a registry of patients with acute coronary syndrome".

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According to their interpretations of HIPAA, hospitals will not reveal information over the phone to relatives of admitted patients. This has, in some instances, impeded the location of missing persons. After the

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by a covered entity regarding health status, provision of health care, or health care payment that can be linked to any individual. This is interpreted rather broadly and includes any part of an individual's

897:. Beginning in 1997, a medical savings account ("MSA") became available to employees covered under an employer-sponsored high deductible plan, these being small employer and self-employed individuals. 2477: 2286: 805:

Controls must govern the introduction and removal of hardware and software from the network. (When equipment is retired it must be disposed of properly to ensure that PHI is not compromised.)

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or payment history. Covered entities must disclose PHI to the individual within 30 days upon request. They must also disclose PHI when required to do so by law such as reporting suspected

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For example, if the new plan offers dental benefits, then it must count creditable continuous coverage under the old health plan towards any of its exclusion periods for dental benefits.

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demonstrated that implementation of the HIPAA Privacy rule resulted in a drop from 96% to 34% in the proportion of follow-up surveys completed by study patients being followed after a

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request the information in electronic form or hard-copy, and the provider is obligated to attempt to conform to the requested format. For providers using an electronic health record (

1059:, variously said to refer to the "Health Information Privacy and Portability Act", "Health Information Privacy Protection Act", or "Health Insurance Privacy and Protection Act". The 504:

An individual who believes that the Privacy Rule is not being upheld can file a complaint with the Department of Health and Human Services Office for Civil Rights (OCR). In 2006 the

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The size of many fields {segment elements} will be expanded, causing a need for all IT providers to expand corresponding fields, element, files, GUI, paper media, and databases.

712:(276) is a transaction set that can be used by a provider, recipient of health care products or services or their authorized agent to request the status of a health care claim. 4772: 817:

Policies are required to address proper workstation use. Workstations should be removed from high traffic areas and monitor screens should not be in direct view of the public.

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Providers can charge a reasonable amount that relates to their cost of providing the copy, however, no charge is allowable when providing data electronically from a certified

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control fraud and abuse within the health-care system. However, the most significant provisions of Title II are its Administrative Simplification rules. Title II requires the

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Procedures should document instructions for addressing and responding to security breaches that are identified either during the audit or the normal course of operations.

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the Health Care claim, there can be slight derivations to cover off claims involving unique claims such as for institutions, professionals, chiropractors, dentists, etc.

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005010 and NCPDP D.0 become effective, replacing the previous ASC X12 004010 and NCPDP 5.1 mandate. The ASC X12 005010 version provides a mechanism allowing the use of

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Entities must show that an appropriate ongoing training program regarding the handling of PHI is provided to employees performing health plan administrative functions.

2452: 1221: 211: 2732:

Kirsch, Michael S. (2004). "Alternative Sanctions and the Federal Tax Law: Symbols, Shaming, and Social Norm Management as a Substitute for Effective Tax Policy".

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Offenses committed with the intent to sell, transfer, or use individually identifiable health information for commercial advantage, personal gain or malicious harm

4747: 4538: 4196: 3461: 2685: 4406: 694:(820), is a transaction set for making a premium payment for insurance products. It can be used to order a financial institution to make a payment to a payee. 1845: 493:

when a covered entity discloses any PHI, it must make a reasonable effort to disclose only the minimum necessary information required to achieve its purpose.

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standard and places responsibility on covered entities to take all reasonable precautions necessary to prevent PHI from being used for non-health purposes.)

4191: 2130: 2083: 2067: 2051: 2000: 1984: 1968: 1952: 1936: 1901: 1885: 1812: 1317: 1308: 1297: 1288: 1279: 675:, or make a payment and send an EOP remittance advice only from a health insurer to a health care provider either directly or via a financial institution. 534:

Protection of PHI was changed from indefinite to 50 years after death. More severe penalties for violation of PHI privacy requirements were also approved.

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Data corroboration, including the use of a checksum, double-keying, message authentication, and digital signature may be used to ensure data integrity.

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article as saying, "Privacy is important, but research is also important for improving care. We hope that we will figure this out and do it right."

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forms for research studies must document how protected health information will be kept private, potentially increasing barriers to participation.

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Wilson J (2006). "Health Insurance Portability and Accountability Act Privacy rule causes ongoing concerns among clinicians and researchers".

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The policies and procedures must reference management oversight and organizational buy-in to compliance with the documented security controls.

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Education and training of healthcare providers is a requirement for correct implementation of both the HIPAA Privacy Rule and Security Rule.

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maintained by the healthcare and healthcare insurance industries should be protected from fraud and theft, and addressed some limitations on

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CSM.gov "Medicare & Medicaid Services" "Standards for Electronic Transactions-New Versions, New Standard and New Code Set – Final Rules"

2359:"2042-What personal health information do individuals have a right under HIPAA to access from their health care providers and health plans?" 2168: 4742: 3456: 453:(HHS) to increase the efficiency of the health-care system by creating standards for the use and dissemination of health-care information. 833:

Each covered entity is responsible for ensuring that the data within its systems has not been changed or erased in an unauthorized manner.

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Department of Justice as criminal actions. Examples of significant breaches of protected information and other HIPAA violations include:

4691: 3402: 2591: 1491: 706:(271) is used to respond to a request inquiry about the health care benefits and eligibility associated with a subscriber or dependent. 310: 3162: 4558: 3597: 3347: 1761: 1746: 1731: 1663: 1646: 1629: 1612: 4566: 4399: 3526: 3140: 589:

An individual may also request (in writing) that their PHI is delivered to a designated third party such as a family care provider.

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alternatives to discontinued plans for as long as the insurer stays in the market without exclusion regardless of health condition.

103: 2976: 2706: 1828: 3357: 2561: 1512: 1374: 748:

Many segments have been added to existing Transaction Sets allowing greater tracking and reporting of cost and patient encounters.

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to be assessed against those deemed to be giving up their U.S. status for tax reasons, and making ex-citizens' names part of the

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If the covered entities utilize contractors or agents, they too must be fully trained on their physical access responsibilities.

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Title II, known as the Administrative Simplification (AS) provisions, requires the establishment of national standards for

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Covered entities and specified individuals who "knowingly" obtain or disclose individually identifiable health information

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Koczkodaj, Waldemar W.; Mazurek, Mirosław; Strzałka, Dominik; Wolny-Dominiak, Alicja; Woodbury-Smith, Marc (2019-01-01).

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Wafa, Tim (Summer 2010). "How the Lack of Prescriptive Technical Granularity in HIPAA Has Compromised Patient Privacy".

470: 302: 193: 120: 2623: 2099: 1588: 4151: 3848: 3794: 3468: 843:

Covered entities must make documentation of their HIPAA practices available to the government to determine compliance.

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OCR Home, Health Information Privacy, HIPAA Administrative Simplification Statute and Rules, Breach Notification Rule

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Administrative Safeguards – policies and procedures designed to clearly show how the entity will comply with the act

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Capacity to use both "International Classification of Diseases" versions 9 (ICD-9) and 10 (ICD-10-CM) has been added.

64:

to long-term care services and coverage, to simplify the administration of health insurance, and for other purposes.

4543: 3799: 3663: 3557: 2405: 1233: 700:(270) is used to inquire about the health care benefits and eligibility associated with a subscriber or dependent. 603: 135: 814:

Required access controls consist of facility security plans, maintenance records, and visitor sign-in and escorts.

671:(835) can be used to make a payment, send an Explanation of Benefits (EOB), send an Explanation of Payments (EOP) 406: 4615: 3878: 3767: 3577: 3478: 2382: 2328: 1100:

According to Koczkodaj et al., 2018, the total number of individuals affected since October 2009 is 173,398,820.

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on August 21, 1996. It aimed to alter the transfer of healthcare information, stipulated the guidelines by which

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Individual did not know (and by exercising reasonable diligence would not have known) that he/she violated HIPAA

44: 4571: 4475: 4251: 4003: 3873: 3853: 3521: 3473: 2951: 582: 571: 332: 3908: 3363: 4434: 4054: 3843: 3711: 3658: 3516: 3506: 3395: 802:

Physical Safeguards – controlling physical access to protect against inappropriate access to protected data

1842: 4696: 4548: 4485: 4146: 3779: 3607: 3102: 2613:"The Looming Problem in Healthcare EDI: ICD-10 and HIPAA 5010 migration" October 10, 2009 – Shahid N. Shah 2430: 2270: 2169:"University of California settles HIPAA Privacy and Security case involving UCLA Health System facilities" 1398: 1245: 1075: 958: 147: 1918: 537:

The HIPAA Privacy rule may be waived during disasters. Limited waivers have been issued in cases such as

386:

Title II: Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reform

4732: 4528: 4495: 4161: 4047: 3976: 3831: 3716: 2033: 1705: 962: 3678: 1469: 4701: 4270: 4213: 3836: 3816: 3643: 3531: 3451: 4329: 4324: 4319: 4304: 4166: 4126: 3888: 3858: 3726: 3587: 3511: 3501: 1088:

The largest loss of data that affected 4.9 million people by Tricare Management of Virginia in 2011

3107:

OCR Home, Health Information Privacy, Enforcement Activities & Results, Enforcement Highlights

1242: 1079:

A breakdown of the HIPAA violations that resulted in the illegal exposure of personal information.

144: 4675: 4429: 4372: 4365: 4277: 4156: 4081: 3898: 3863: 3774: 3731: 3701: 3673: 3668: 3638: 3612: 3436: 3388: 3295: 3221: 2892: 2791: 1570: 1142:

HIPAA violation due to willful neglect but violation is corrected within the required time period

975:

These data suggest that HIPAA privacy rules may have negative effects on the cost and quality of

2887: 1268: 1264: 234: 1258: 808:

Access to equipment containing health information should be carefully controlled and monitored.

779:

The procedures must address access authorization, establishment, modification, and termination.

189: 4650: 4625: 4470: 4442: 4226: 4096: 3988: 3952: 3942: 3903: 3893: 3821: 3811: 3741: 3287: 3213: 3027: 2868: 2827: 2783: 2741: 2650: 2646: 2583: 2537: 2195: 1865: 1562: 1446: 1366: 1064: 980: 672: 2745: 1483: 4523: 4339: 4294: 4239: 4231: 4221: 3998: 3922: 3762: 3736: 3721: 3628: 3446: 3428: 3279: 3205: 3075: 3017: 3009: 2858: 2819: 2779: 2775: 2529: 2025: 1693: 1554: 1358: 1103:

The differences between civil and criminal penalties are summarized in the following table:

976: 969: 924: 538: 174: 80: 3344: 335:

transactions and national identifiers for providers, health insurance plans, and employers.

4706: 4635: 4351: 4314: 4290: 4091: 4086: 4066: 4025: 4020: 3967: 3962: 3826: 3806: 3683: 3648: 3351: 2689: 2670: 2290: 2152: 1872: 1849: 1718: 1213: 298: 292: 3132: 2517: 469:

The HIPAA Privacy Rule is composed of national regulations for the use and disclosure of

2133: 2086: 2070: 2054: 2016:

Rowe, Linda (2005). "What Judicial Officers Need to Know about the HIPAA Privacy Rule".

2003: 1987: 1971: 1955: 1939: 1904: 1888: 1815: 739:

Transaction Set (997) will be replaced by Transaction Set (999) "acknowledgment report".

4665: 4620: 4610: 4605: 4581: 4460: 4452: 4257: 4106: 3789: 3653: 3547: 3493: 1349: 478: 3022: 2997: 1735: 4721: 4670: 4655: 4630: 4503: 4060: 3981: 3929: 3868: 3706: 3572: 3299: 3225: 2492: 2100:"How to File A Health Information Privacy Complaint with the Office for Civil Rights" 1780: 1765: 1750: 1039: 928: 2795: 2383:"Individuals' Right under HIPAA to Access their Health Information 45 CFR § 164.524" 2145: 4660: 4592: 4309: 4121: 4116: 4076: 4037: 3268:"Book Review: Congressional Quarterly Almanac: 81st Congress, 2nd Session. Vol. VI" 811:

Access to hardware and software must be limited to properly authorized individuals.

306: 266: 1667: 1650: 1633: 1616: 2823: 2187: 1320: 1311: 1300: 1291: 1282: 1145:$ 10,000 per violation, with an annual maximum of $ 250,000 for repeat violations 4645: 4465: 4344: 4299: 3972: 3757: 3267: 1225: 1217: 1134:$ 1,000 per violation, with an annual maximum of $ 100,000 for repeat violations 482: 395: 288: 3283: 2037: 1438: 919:

to interest allocation rules. Finally, it amends provisions of law relating to

611: 4518: 4415: 4384: 4243: 4235: 4111: 4032: 3993: 3937: 3370:

Full text of the Health Insurance Portability and Accountability Act (PDF/TXT)

3209: 2221:"Explaining HIPAA: No, it doesn't ban questions about your vaccination status" 623:

all health plans to engage in health care transactions in a standardized way.

593:

prenatal visit to a pregnancy self-care app that she has on her mobile phone.

558: 248: 220: 3291: 3217: 2952:"HIPAA, the health privacy law that's more limited than you think, explained" 2493:"TITLE XI—General Provisions, Peer Review, and Administrative Simplification" 2305:"HHS releases limited HIPAA waiver during Hurricane Harvey: 5 things to know" 2245:"Lawmaker Marjorie Taylor Greene, in Ten Words or Less, Gets HIPAA All Wrong" 2199: 2106: 1566: 1362: 1123:$ 100 per violation, with an annual maximum of $ 25,000 for repeat violations 4513: 4285: 4101: 4071: 4042: 3784: 3411: 3314:"The Health Insurance Portability and Accountability Act (HIPAA) | Colleaga" 3193: 3036:

The Health Insurance Privacy and Portability Act (HIPPA) stipulates that ...

2533: 944:

among physicians and medical centers. An August 2006 article in the journal

901:

Title IV: Application and enforcement of group health insurance requirements

635: 328:

coverage for workers and their families when they change or lose their jobs.

3031: 2872: 2831: 2787: 2541: 2029: 1689: 1450: 1306:

HHS Standards for Privacy of Individually Identifiable Health Information,

889:

Title III: Tax-related health provisions governing medical savings accounts

2984:

violation of the Health Information Privacy and Portability Act. ("HIPPA")

1697: 1370: 948:

detailed some such concerns over the implementation and effects of HIPAA.

4009: 2474:"New York Times Examines 'Unintended Consequences' of HIPAA Privacy Rule" 1342:"The Politics Of The Health Insurance Portability And Accountability Act" 1253: 166: 3013: 4600: 4533: 3947: 3883: 2863: 2847:"Local perspective of the impact of the HIPAA privacy rule on research" 2846: 1574: 1542: 631: 420: in this section. Unsourced material may be challenged and removed. 69: 2998:"The Effects of Promoting Patient Access to Medical Records: A Review" 2707:"Feds step up HIPAA enforcement with hospice settlement - SC Magazine" 1131:

HIPAA violation due to reasonable cause and not due to willful neglect

4576: 3602: 17: 2664:

Health Insurance Portability and Accountability Act of 1996 (HIPAA).

1558: 893:

Title III standardizes the amount that may be saved per person in a

2329:"Individuals' Right under HIPAA to Access their Health Information" 1437:

Edemekong, Peter F.; Annamaraju, Pavan; Haydel, Micelle J. (2023),

4262: 1074: 933:

Quarterly Publication of Individuals Who Have Chosen to Expatriate

658: 555:

Health Information Technology for Economic and Clinical Health Act

201: 31: 30:"HIPPA" redirects here. For the genus of decapod crustaceans, see 3375: 1855:

journal, volume 19, number 3, year 2009, access date July 2, 2009

3957: 3243:"Health Insurance Portability and Accountability Act - LIMSWiki" 3169:. U.S. Department of Health & Human Services. October 2010. 2385:. U.S. Department of Health & Human Services. 5 January 2016 1159:$ 50,000 per violation, with an annual maximum of $ 1.5 million 1148:$ 50,000 per violation, with an annual maximum of $ 1.5 million 1137:$ 50,000 per violation, with an annual maximum of $ 1.5 million 1126:$ 50,000 per violation, with an annual maximum of $ 1.5 million 338:

Title III sets guidelines for pre-tax medical spending accounts.

4388: 3384: 1422:"Health insurance portability and accountability act of 1996". 745:

Some segments have been removed from existing Transaction Sets.

1153:

HIPAA violation is due to willful neglect and is not corrected

914:

Title V: Revenue offset governing tax deductions for employers

389: 1484:"Health Plans & Benefits: Portability of Health Coverage" 1156:$ 50,000 per violation, with an annual maximum of $ 1,000,000 3380: 3364:

Congressional Research Service (CRS) reports regarding HIPAA

2518:"HIPAA compliance date for electronic transactions extended" 3049:"No, asking if you are vaccinated is not a HIPAA violation" 2431:"Asiana fined $ 500,000 for failing to help families - CNN" 280:

Health Insurance Portability and Accountability Act of 1996

95: 38:

Health Insurance Portability and Accountability Act of 1996

734:

Brief 5010 Transactions and Code Sets Rules Update Summary

527:

originally been held to uphold these sections of the law.

357:

Title I: Health Care Access, Portability, and Renewability

89: 3194:"Electronic Health Record Breaches as Social Indicators" 1807: 1805: 1541:

Berger, Mark C.; Black, Dan A.; Scott, Frank A. (2004).

501:

members of their workforce in procedures regarding PHI.

3077:"Another Thing to Fear Out There: Coronavirus Scammers" 3002:

Journal of the American Medical Informatics Association

2449:"First Amendment Center | Freedom Forum Institute" 27:

United States federal law concerning health information

2722:

Feds step up HIPAA enforcement with hospice settlement

858:

Unique Identifiers Rule (National Provider Identifier)

344:

Title V governs company-owned life insurance policies.

2188:"How the HIPAA Law Works and Why People Get It Wrong" 1781:"42 U.S. Code § 1395ddd - Medicare Integrity Program" 1439:"Health Insurance Portability and Accountability Act" 1340:

Atchinson, Brian K.; Fox, Daniel M. (May–June 1997).

883:

United States Department of Health and Human Services

531:

organizations must prove that harm had not occurred.

353:

There are five sections to the act, known as titles.

104: 1543:"Is There Job Lock? Evidence from the Pre-HIPAA Era" 669:

EDI Health Care Claim Payment/Advice Transaction Set

92: 4684: 4590: 4557: 4494: 4481:

Health Insurance Portability and Accountability Act

4451: 4422: 4212: 4137: 3921: 3750: 3692: 3621: 3540: 3492: 3427: 3418: 1053:

Health Insurance Portability and Accountability Act

172: 153: 131: 126: 115: 86: 83: 68: 59: 51: 3360:, Centers for Medicare and Medicaid Services (CMS) 3139:. U.S. Department of Health & Human Services. 3109:. U.S. Department of Health & Human Services. 2888:"Keeping Patients' Details Private, Even From Kin" 2269:(OCR), Office for Civil Rights (30 October 2015). 2146:"Spread of records stirs fears of privacy erosion" 1234: 1051:matches the title of the 1996 Public Law 104-191, 136: 3074:LaFraniere, Sharon; Hamby, Chris (5 April 2020). 2626:. American Medical Association. 14 December 2023. 983:at the University of Michigan, was quoted in the 1690:"HIPAA for Healthcare Workers: The Privacy Rule" 1055:, HIPAA is sometimes incorrectly referred to as 610:Janlori Goldman, director of the advocacy group 341:Title IV sets guidelines for group health plans. 1445:, Treasure Island (FL): StatPearls Publishing, 1028:"People make up what that acronym stands for." 1026: 874: 4539:Participative decision-making in organizations 728:EDI Functional Acknowledgement Transaction Set 642:on January 16, 2009), and on the CMS website. 497:number instead of home or cell phone numbers. 4400: 3396: 2404:Rights (OCR), Office for Civil (2009-11-20). 2357:Rights (OCR), Office for Civil (2016-06-24). 1917:(OCR), Office for Civil Rights (7 May 2008). 8: 3133:"Breaches Affecting 500 or more Individuals" 1261:; H. Rept. 104–469, part 1; H. Rept. 104-736 921:people who give up United States citizenship 704:EDI Health Care Eligibility/Benefit Response 55:Kassebaum–Kennedy Act, Kennedy–Kassebaum Act 37: 4773:United States federal insurance legislation 2945: 2943: 2171:. Department of Health and Human Services. 1829:"Other Administrative Simplification Rules" 698:EDI Health Care Eligibility/Benefit Inquiry 4407: 4393: 4385: 3424: 3403: 3389: 3381: 2522:American Journal of Health-System Pharmacy 2284:Health Information of Deceased Individuals 722:EDI Health Care Service Review Information 681:EDI Benefit Enrollment and Maintenance Set 241:Reported by the joint conference committee 4768:United States federal privacy legislation 3345:California Office of HIPAA Implementation 3021: 2934:"Federal Register :: Request Access" 2920:"Federal Register :: Request Access" 2862: 2761: 2759: 2757: 2755: 2624:"HIPAA security rule & risk analysis" 716:EDI Health Care Claim Status Notification 436:Learn how and when to remove this message 4763:United States federal health legislation 4728:Acts of the 104th United States Congress 1183:Offenses committed under false pretenses 1105: 1092:ignoring of federal officials' inquiries 2780:10.7326/0003-4819-145-4-200608150-00019 2639:Northern Illinois University Law Review 1775: 1773: 1332: 657:EDI Retail Pharmacy Claim Transaction ( 451:Department of Health and Human Services 2594:from the original on 12 February 2012. 2155:, December 23, 2006, by Theo Francis, 1714: 1703: 923:or permanent residence, expanding the 692:Premium Payment for Insurance Products 36: 4748:Medicare and Medicaid (United States) 4567:Health information on Knowledge (XXG) 3376:Office for Civil Rights page on HIPAA 3366:, University of North Texas Libraries 3237: 3235: 2572:from the original on 18 October 2017. 2491:U.S. Social Security Administration. 1925:from the original on 6 December 2015. 1399:"104th Congress, 1st Session, S.1028" 939:Effects on research and clinical care 647:EDI Health Care Claim Transaction Set 511:University of California, Los Angeles 7: 2900:from the original on August 12, 2017 2673:Steve Anderson: HealthInsurance.org. 2429:Ahlers, Mike M. (25 February 2014). 2406:"Summary of the HIPAA Security Rule" 1063:misspelling has been observed among 710:EDI Health Care Claim Status Request 418:adding citations to reliable sources 3173:from the original on 8 October 2017 1919:"Summary of the HIPAA Privacy Rule" 1866:45 CFR Sections 160.102 and 160.103 1843:"Patient Privacy - The New Threats" 311:personally identifiable information 4559:Health information on the Internet 3442:Accidental death and dismemberment 3143:from the original on 15 March 2015 2683:Medical Privacy Law Nets No Fines. 1239:Tooltip Public Law (United States) 1037:deputy director, as quoted in 141:Tooltip Public Law (United States) 25: 3113:from the original on 5 March 2014 2303:Cohen, Jessica Kim (2017-08-30). 1785:LII / Legal Information Institute 1488:United States Department of Labor 485:to state child welfare agencies. 305:and signed into law by President 4753:Privacy law in the United States 3568:Directors and officers liability 2950:Morrison, Sara (20 April 2021). 2480:from the original on 6 May 2016. 2437:from the original on 2014-02-27. 2175:from the original on 2017-10-12. 1411:from the original on 2012-06-16. 545:HITECH Act: privacy requirements 394: 79: 43: 4692:Open-source healthcare software 3372:U.S. Government Printing Office 2713:from the original on 2013-01-09 2455:from the original on 2016-06-05 2339:from the original on 2017-12-02 1791:from the original on 2018-03-21 1523:from the original on 2016-11-02 1494:from the original on 2016-12-20 895:pre-tax medical savings account 638:as well as other improvements. 618:Transactions and Code Sets Rule 405:needs additional citations for 2977:"United States District Court" 2186:Kavi, Aishvarya (2021-07-22). 979:. Dr. Kim Eagle, professor of 522:2013 Final Omnibus Rule update 320:The act consists of 5 titles: 1: 2309:www.beckershospitalreview.com 872:prosecutions for violations. 315:healthcare insurance coverage 4335:Savings and loan association 2886:Gross, Jane (July 3, 2007). 2824:10.1001/archinte.165.10.1125 2219:Chiu, Allyson (2021-05-22). 1199:Imprisonment up to 10 years 931:through the creation of the 471:Protected Health Information 303:104th United States Congress 121:104th United States Congress 4743:Medical privacy legislation 4509:Doctor–patient relationship 4416:Telemedicine and telehealth 3768:Insurance-linked securities 1188:Imprisonment up to 5 years 946:Annals of Internal Medicine 628:electronic data interchange 4789: 4544:Patient Activation Measure 3457:Total permanent disability 3284:10.1177/107769905102800313 3198:Social Indicators Research 2845:Wolf M, Bennett C (2006). 2271:"Omnibus HIPAA Rulemaking" 1197:A fine of up to $ 250,000 1186:A fine of up to $ 100,000 1177:Imprisonment up to 1 year 604:Asiana Airlines Flight 214 29: 4616:Remote patient monitoring 4360: 4197:Health insurance coverage 3462:Business overhead expense 3210:10.1007/s11205-018-1837-z 1589:"HIPAA Title Information" 1547:Southern Economic Journal 1175:A fine of up to $ 50,000 565:Right to access one's PHI 181: 42: 4572:Online patient education 4476:Electronic health record 3598:Protection and indemnity 3266:Cade, Dozier C. (1951). 3103:"Enforcement Highlights" 1363:10.1377/hlthaff.16.3.146 1222:Ways and Means Committee 991:Effects on clinical care 255:on August 2, 1996 ( 247:on August 1, 1996 ( 229:on April 23, 1996 ( 219:on March 28, 1996 ( 4055:Explanation of benefits 3527:Variable universal life 2157:The Wall Street Journal 1207:Legislative information 1000:Costs of implementation 597:Disclosure to relatives 208:Committee consideration 4697:Patient opinion leader 4549:Shared decision-making 4486:Personal health record 4192:Health insurance costs 3593:Professional liability 2982:. September 16, 2010. 2516:Traynor, Kate (2002). 2030:10.2202/0027-6014.1537 1713:Cite journal requires 1470:"Your Medical Records" 1080: 1030: 1009:Education and training 959:University of Michigan 881:As of March 2013, the 879: 612:Health Privacy Project 333:electronic health care 245:agreed to by the House 4738:Insurance legislation 4529:Knowledge translation 4496:Patient participation 4048:Out-of-pocket expense 3909:Workers' compensation 3563:Collateral protection 3553:Business interruption 3163:"Civil Money Penalty" 2534:10.1093/ajhp/59.5.402 1698:10.4135/9781529727890 1078: 1047:Although the acronym 1033:Deven McGraw, former 690:, and another group, 297:) is a United States 4702:Research participant 4271:Corpus Juris Civilis 3272:Journalism Quarterly 3055:. September 13, 2021 1668:§ 1181(c)(2)(A) 1277:Security Standards, 1115:CIVIL Penalty (max) 688:EDI Payroll Deducted 414:improve this article 212:House Ways and Means 4758:Security compliance 4423:Background concepts 4330:Rochdale Principles 4325:Mutual savings bank 4320:Mutual organization 4305:Cooperative banking 4222:Mesopotamian banker 3502:Longevity insurance 3014:10.1197/jamia.M1147 2996:S. E. Ross (2003). 2694:The Washington Post 1853:Physicians Practice 1472:. 19 November 2008. 1112:CIVIL Penalty (min) 952:Effects on research 564: 506:Wall Street Journal 204:) on March 18, 1996 175:Legislative history 39: 4676:Telerehabilitation 4430:Health informatics 4082:Insurable interest 3583:Payment protection 3484:Payment protection 3350:2012-11-01 at the 3082:The New York Times 2893:The New York Times 2864:10.1002/cncr.21599 2709:. 7 January 2013. 2688:2017-10-13 at the 2669:2014-01-08 at the 2289:2017-10-19 at the 2192:The New York Times 2151:2017-07-10 at the 1871:2012-01-12 at the 1848:2015-11-20 at the 1831:. 4 December 2015. 1271:; S. Rept. 104-156 1081: 661:Telecommunications 269:on August 21, 1996 243:on July 31, 1996; 77:HIPAA (pronounced 52:Other short titles 4715: 4714: 4651:Teleophthalmology 4641:Telemental health 4626:Tele-epidemiology 4471:De-identification 4443:Telecommunication 4382: 4381: 4227:Code of Hammurabi 4202:Vehicle insurance 4097:Replacement value 3989:Actual cash value 3953:Adverse selection 3943:Actuarial science 3917: 3916: 3849:Kidnap and ransom 3822:Extended warranty 3469:Income protection 3167:HHS Official Site 2590:. 28 March 2016. 1651:§ 1181(c)(1) 1634:§ 1181(a)(3) 1617:§ 1181(a)(2) 1204: 1203: 1167:CRIMINAL Penalty 1164:Type of Violation 1109:Type of Violation 1065:COVID-19 scammers 981:internal medicine 673:remittance advice 446: 445: 438: 324:Title I protects 276: 275: 227:Passed the Senate 156:Statutes at Large 16:(Redirected from 4780: 4524:Health education 4409: 4402: 4395: 4386: 4340:Social insurance 4295:Friendly society 4187:Health insurance 4015:Short rate table 3763:Catastrophe bond 3664:Lenders mortgage 3425: 3405: 3398: 3391: 3382: 3333: 3332: 3330: 3329: 3320:. 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Archived from 1346: 1337: 1323: 1314: 1303: 1294: 1285: 1240: 1236: 1106: 1043: 977:medical research 970:informed consent 925:expatriation tax 867:Enforcement Rule 539:Hurricane Harvey 489:missing person. 441: 434: 430: 427: 421: 398: 390: 326:health insurance 217:Passed the House 188:in the House as 177: 157: 142: 138: 107: 102: 101: 98: 97: 94: 91: 88: 85: 74: 47: 40: 21: 4788: 4787: 4783: 4782: 4781: 4779: 4778: 4777: 4718: 4717: 4716: 4711: 4707:Virtual patient 4680: 4636:Teledermatology 4586: 4553: 4490: 4447: 4418: 4413: 4383: 4378: 4356: 4352:Insurance cycle 4315:Fraternal order 4208: 4139: 4133: 4092:Proximate cause 4087:Insurance fraud 4067:General average 4026:Claims adjuster 3968:Risk management 3963:Risk assessment 3927: 3924: 3913: 3879:Prize indemnity 3746: 3694: 3688: 3617: 3578:Over-redemption 3536: 3488: 3479:National health 3420: 3414: 3409: 3352:Wayback Machine 3341: 3336: 3327: 3325: 3312: 3311: 3307: 3265: 3264: 3260: 3251: 3249: 3241: 3240: 3233: 3191: 3190: 3186: 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2225:Washington Post 2218: 2217: 2213: 2204: 2202: 2185: 2184: 2180: 2167: 2166: 2162: 2153:Wayback Machine 2144: 2140: 2129: 2128: 2124: 2115: 2113: 2109: 2102: 2098: 2097: 2093: 2082: 2081: 2077: 2066: 2065: 2061: 2050: 2049: 2045: 2015: 2014: 2010: 1999: 1998: 1994: 1983: 1982: 1978: 1967: 1966: 1962: 1951: 1950: 1946: 1935: 1934: 1930: 1916: 1915: 1911: 1900: 1899: 1895: 1884: 1883: 1879: 1873:Wayback Machine 1863: 1859: 1850:Wayback Machine 1840: 1836: 1827: 1826: 1822: 1811: 1810: 1803: 1794: 1792: 1779: 1778: 1771: 1760: 1756: 1745: 1741: 1736:§ 1320a-7c 1730: 1726: 1712: 1702: 1688: 1687: 1683: 1679:(Sub B Sec 111) 1678: 1674: 1662: 1661: 1657: 1645: 1644: 1640: 1628: 1627: 1623: 1611: 1610: 1606: 1597: 1595: 1593:www.dhcs.ca.gov 1587: 1586: 1582: 1559:10.2307/4135282 1540: 1539: 1535: 1526: 1524: 1511: 1510: 1506: 1497: 1495: 1482: 1481: 1477: 1468: 1467: 1463: 1455: 1453: 1436: 1435: 1431: 1421: 1420: 1416: 1408: 1401: 1397: 1396: 1392: 1383: 1381: 1377: 1344: 1339: 1338: 1334: 1330: 1316: 1307: 1296: 1287: 1278: 1238: 1214:Nancy Kassebaum 1209: 1073: 1045: 1032: 1024: 1019:Misspelling as 1011: 1002: 993: 954: 941: 916: 910:clarification. 903: 891: 869: 860: 758: 736: 626:The HIPAA/EDI ( 620: 599: 567: 551:Privacy section 547: 524: 467: 442: 431: 425: 422: 411: 399: 388: 359: 351: 301:enacted by the 299:Act of Congress 272: 263:Signed into law 173: 155: 140: 116:Enacted by 105: 82: 78: 72: 35: 28: 23: 22: 15: 12: 11: 5: 4786: 4784: 4776: 4775: 4770: 4765: 4760: 4755: 4750: 4745: 4740: 4735: 4730: 4720: 4719: 4713: 4712: 4710: 4709: 4704: 4699: 4694: 4688: 4686: 4682: 4681: 4679: 4678: 4673: 4668: 4666:Telepsychiatry 4663: 4658: 4653: 4648: 4643: 4638: 4633: 4628: 4623: 4621:Tele-audiology 4618: 4613: 4611:Remote therapy 4608: 4606:Remote surgery 4603: 4597: 4595: 4593:subspecialties 4588: 4587: 4585: 4584: 4582:PubMed Central 4579: 4574: 4569: 4563: 4561: 4555: 4554: 4552: 4551: 4546: 4541: 4536: 4531: 4526: 4521: 4516: 4511: 4506: 4500: 4498: 4492: 4491: 4489: 4488: 4483: 4478: 4473: 4468: 4463: 4461:Admission note 4457: 4455: 4453:Medical record 4449: 4448: 4446: 4445: 4440: 4432: 4426: 4424: 4420: 4419: 4414: 4412: 4411: 4404: 4397: 4389: 4380: 4379: 4377: 4376: 4373:List of topics 4369: 4361: 4358: 4357: 4355: 4354: 4349: 4348: 4347: 4342: 4337: 4332: 4327: 4322: 4317: 4312: 4307: 4302: 4288: 4283: 4282: 4281: 4267: 4266: 4265: 4260: 4258:Burial society 4248: 4247: 4246: 4240:§235–238; §240 4232:§100–105; §126 4224: 4218: 4216: 4210: 4209: 4207: 4206: 4205: 4204: 4199: 4194: 4189: 4184: 4182:Climate change 4174: 4172:United Kingdom 4169: 4164: 4159: 4154: 4149: 4143: 4141: 4135: 4134: 4132: 4131: 4130: 4129: 4119: 4117:Underinsurance 4114: 4109: 4107:Self-insurance 4104: 4099: 4094: 4089: 4084: 4079: 4074: 4069: 4064: 4057: 4052: 4051: 4050: 4045: 4040: 4030: 4029: 4028: 4018: 4017: 4016: 4013: 4001: 3996: 3991: 3986: 3985: 3984: 3979: 3970: 3965: 3960: 3955: 3950: 3940: 3934: 3932: 3919: 3918: 3915: 3914: 3912: 3911: 3906: 3901: 3896: 3891: 3886: 3881: 3876: 3874:Political risk 3871: 3866: 3861: 3856: 3854:Legal expenses 3851: 3846: 3841: 3840: 3839: 3829: 3824: 3819: 3814: 3809: 3804: 3803: 3802: 3797: 3787: 3782: 3777: 3772: 3771: 3770: 3765: 3754: 3752: 3748: 3747: 3745: 3744: 3739: 3734: 3729: 3724: 3719: 3714: 3709: 3704: 3698: 3696: 3690: 3689: 3687: 3686: 3681: 3676: 3671: 3666: 3661: 3656: 3651: 3646: 3641: 3636: 3634:Builder's risk 3631: 3625: 3623: 3619: 3618: 3616: 3615: 3610: 3605: 3600: 3595: 3590: 3585: 3580: 3575: 3570: 3565: 3560: 3558:Business owner 3555: 3550: 3544: 3542: 3538: 3537: 3535: 3534: 3529: 3524: 3522:Universal life 3519: 3514: 3509: 3504: 3498: 3496: 3490: 3489: 3487: 3486: 3481: 3476: 3474:Long-term care 3471: 3466: 3465: 3464: 3459: 3449: 3444: 3439: 3433: 3431: 3422: 3416: 3415: 3410: 3408: 3407: 3400: 3393: 3385: 3379: 3378: 3373: 3367: 3361: 3355: 3340: 3339:External links 3337: 3335: 3334: 3305: 3278:(3): 389–390. 3258: 3231: 3204:(2): 861–871. 3184: 3154: 3124: 3094: 3066: 3040: 3008:(2): 129–138. 2988: 2968: 2939: 2925: 2911: 2878: 2837: 2818:(10): 1125–9. 2801: 2768:Ann Intern Med 2751: 2724: 2698: 2675: 2656: 2629: 2615: 2606: 2597: 2575: 2553: 2508: 2483: 2465: 2440: 2421: 2396: 2374: 2349: 2335:. 2016-01-05. 2320: 2295: 2276: 2261: 2236: 2211: 2178: 2160: 2138: 2122: 2091: 2075: 2059: 2043: 2024:(4): 498–512. 2008: 1992: 1976: 1960: 1944: 1928: 1909: 1893: 1877: 1857: 1834: 1820: 1801: 1769: 1766:§ 1395b-5 1762:42 U.S.C. 1754: 1751:§ 1395ddd 1747:42 U.S.C. 1739: 1732:42 U.S.C. 1724: 1715:|journal= 1681: 1672: 1655: 1638: 1621: 1604: 1580: 1553:(4): 953–976. 1533: 1519:. 2016-09-13. 1504: 1490:. 2015-12-09. 1475: 1461: 1429: 1414: 1390: 1357:(3): 146–150. 1350:Health Affairs 1331: 1329: 1326: 1325: 1324: 1304: 1272: 1262: 1259:H.R. 3103 1256: 1243:104–191 (text) 1208: 1205: 1202: 1201: 1195: 1191: 1190: 1184: 1180: 1179: 1173: 1169: 1168: 1165: 1161: 1160: 1157: 1154: 1150: 1149: 1146: 1143: 1139: 1138: 1135: 1132: 1128: 1127: 1124: 1121: 1117: 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4672: 4671:Teleradiology 4669: 4667: 4664: 4662: 4659: 4657: 4656:Telepathology 4654: 4652: 4649: 4647: 4644: 4642: 4639: 4637: 4634: 4632: 4631:Teledentistry 4629: 4627: 4624: 4622: 4619: 4617: 4614: 4612: 4609: 4607: 4604: 4602: 4599: 4598: 4596: 4594: 4591:Telemedicine 4589: 4583: 4580: 4578: 4575: 4573: 4570: 4568: 4565: 4564: 4562: 4560: 4556: 4550: 4547: 4545: 4542: 4540: 4537: 4535: 4532: 4530: 4527: 4525: 4522: 4520: 4517: 4515: 4512: 4510: 4507: 4505: 4504:Decision aids 4502: 4501: 4499: 4497: 4493: 4487: 4484: 4482: 4479: 4477: 4474: 4472: 4469: 4467: 4464: 4462: 4459: 4458: 4456: 4454: 4450: 4444: 4441: 4439: 4437: 4433: 4431: 4428: 4427: 4425: 4421: 4417: 4410: 4405: 4403: 4398: 4396: 4391: 4390: 4387: 4375: 4374: 4370: 4368: 4367: 4363: 4362: 4359: 4353: 4350: 4346: 4343: 4341: 4338: 4336: 4333: 4331: 4328: 4326: 4323: 4321: 4318: 4316: 4313: 4311: 4308: 4306: 4303: 4301: 4298: 4297: 4296: 4292: 4289: 4287: 4284: 4280: 4279: 4275: 4274: 4273: 4272: 4268: 4264: 4261: 4259: 4256: 4255: 4254: 4253: 4249: 4245: 4241: 4237: 4233: 4230: 4229: 4228: 4225: 4223: 4220: 4219: 4217: 4215: 4211: 4203: 4200: 4198: 4195: 4193: 4190: 4188: 4185: 4183: 4180: 4179: 4178: 4177:United States 4175: 4173: 4170: 4168: 4165: 4163: 4160: 4158: 4155: 4153: 4150: 4148: 4145: 4144: 4142: 4136: 4128: 4125: 4124: 4123: 4120: 4118: 4115: 4113: 4110: 4108: 4105: 4103: 4100: 4098: 4095: 4093: 4090: 4088: 4085: 4083: 4080: 4078: 4075: 4073: 4070: 4068: 4065: 4063: 4062: 4061:Force majeure 4058: 4056: 4053: 4049: 4046: 4044: 4041: 4039: 4036: 4035: 4034: 4031: 4027: 4024: 4023: 4022: 4019: 4014: 4012: 4011: 4007: 4006: 4005: 4002: 4000: 3997: 3995: 3992: 3990: 3987: 3983: 3982:Value of life 3980: 3978: 3974: 3971: 3969: 3966: 3964: 3961: 3959: 3956: 3954: 3951: 3949: 3946: 3945: 3944: 3941: 3939: 3936: 3935: 3933: 3931: 3926: 3920: 3910: 3907: 3905: 3902: 3900: 3897: 3895: 3892: 3890: 3887: 3885: 3882: 3880: 3877: 3875: 3872: 3870: 3867: 3865: 3862: 3860: 3857: 3855: 3852: 3850: 3847: 3845: 3844:Interest rate 3842: 3838: 3835: 3834: 3833: 3830: 3828: 3825: 3823: 3820: 3818: 3815: 3813: 3810: 3808: 3805: 3801: 3798: 3796: 3793: 3792: 3791: 3788: 3786: 3783: 3781: 3778: 3776: 3773: 3769: 3766: 3764: 3761: 3760: 3759: 3756: 3755: 3753: 3749: 3743: 3740: 3738: 3735: 3733: 3730: 3728: 3725: 3723: 3720: 3718: 3715: 3713: 3712:Inland marine 3710: 3708: 3707:GAP insurance 3705: 3703: 3700: 3699: 3697: 3695:Communication 3691: 3685: 3682: 3680: 3677: 3675: 3672: 3670: 3667: 3665: 3662: 3660: 3657: 3655: 3652: 3650: 3647: 3645: 3642: 3640: 3637: 3635: 3632: 3630: 3627: 3626: 3624: 3620: 3614: 3611: 3609: 3606: 3604: 3601: 3599: 3596: 3594: 3591: 3589: 3586: 3584: 3581: 3579: 3576: 3574: 3571: 3569: 3566: 3564: 3561: 3559: 3556: 3554: 3551: 3549: 3546: 3545: 3543: 3539: 3533: 3530: 3528: 3525: 3523: 3520: 3518: 3517:Unitised fund 3515: 3513: 3510: 3508: 3507:Mortgage life 3505: 3503: 3500: 3499: 3497: 3495: 3491: 3485: 3482: 3480: 3477: 3475: 3472: 3470: 3467: 3463: 3460: 3458: 3455: 3454: 3453: 3450: 3448: 3445: 3443: 3440: 3438: 3435: 3434: 3432: 3430: 3426: 3423: 3417: 3413: 3406: 3401: 3399: 3394: 3392: 3387: 3386: 3383: 3377: 3374: 3371: 3368: 3365: 3362: 3359: 3356: 3353: 3349: 3346: 3343: 3342: 3338: 3324:on 2021-10-10 3323: 3319: 3315: 3309: 3306: 3301: 3297: 3293: 3289: 3285: 3281: 3277: 3273: 3269: 3262: 3259: 3248: 3244: 3238: 3236: 3232: 3227: 3223: 3219: 3215: 3211: 3207: 3203: 3199: 3195: 3188: 3185: 3172: 3168: 3164: 3158: 3155: 3142: 3138: 3134: 3128: 3125: 3112: 3108: 3104: 3098: 3095: 3083: 3078: 3070: 3067: 3054: 3050: 3044: 3041: 3037: 3033: 3029: 3024: 3019: 3015: 3011: 3007: 3003: 2999: 2992: 2989: 2985: 2978: 2972: 2969: 2957: 2953: 2946: 2944: 2940: 2935: 2929: 2926: 2921: 2915: 2912: 2899: 2895: 2894: 2889: 2882: 2879: 2874: 2870: 2865: 2860: 2856: 2852: 2848: 2841: 2838: 2833: 2829: 2825: 2821: 2817: 2813: 2805: 2802: 2797: 2793: 2789: 2785: 2781: 2777: 2773: 2769: 2762: 2760: 2758: 2756: 2752: 2747: 2743: 2739: 2735: 2728: 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1941: 1938: 1932: 1929: 1924: 1920: 1913: 1910: 1906: 1903: 1897: 1894: 1890: 1887: 1881: 1878: 1874: 1870: 1867: 1861: 1858: 1854: 1851: 1847: 1844: 1838: 1835: 1830: 1824: 1821: 1817: 1814: 1808: 1806: 1802: 1790: 1786: 1782: 1776: 1774: 1770: 1767: 1763: 1758: 1755: 1752: 1748: 1743: 1740: 1737: 1733: 1728: 1725: 1720: 1707: 1699: 1695: 1691: 1685: 1682: 1676: 1673: 1669: 1665: 1659: 1656: 1652: 1648: 1642: 1639: 1635: 1631: 1625: 1622: 1618: 1614: 1608: 1605: 1594: 1590: 1584: 1581: 1576: 1572: 1568: 1564: 1560: 1556: 1552: 1548: 1544: 1537: 1534: 1522: 1518: 1514: 1508: 1505: 1493: 1489: 1485: 1479: 1476: 1471: 1465: 1462: 1452: 1448: 1444: 1440: 1433: 1430: 1425: 1418: 1415: 1407: 1400: 1394: 1391: 1380:on 2014-01-16 1376: 1372: 1368: 1364: 1360: 1356: 1352: 1351: 1343: 1336: 1333: 1327: 1322: 1319: 1313: 1310: 1305: 1302: 1299: 1293: 1290: 1284: 1281: 1276: 1273: 1270: 1266: 1263: 1260: 1257: 1255: 1251: 1247: 1244: 1237: 1232: 1231: 1230: 1227: 1223: 1219: 1215: 1206: 1200: 1196: 1193: 1192: 1189: 1185: 1182: 1181: 1178: 1174: 1171: 1170: 1166: 1163: 1162: 1158: 1155: 1152: 1151: 1147: 1144: 1141: 1140: 1136: 1133: 1130: 1129: 1125: 1122: 1119: 1118: 1114: 1111: 1108: 1107: 1104: 1101: 1094: 1090: 1087: 1086: 1085: 1077: 1070: 1068: 1066: 1062: 1058: 1054: 1050: 1044: 1042: 1041: 1036: 1029: 1022: 1018: 1016: 1014: 1008: 1006: 999: 997: 990: 988: 986: 982: 978: 973: 971: 968:Under HIPAA, 966: 964: 960: 951: 949: 947: 938: 936: 934: 930: 929:public record 926: 922: 913: 911: 909: 900: 898: 896: 888: 886: 884: 878: 873: 866: 864: 857: 849: 845: 842: 838: 835: 832: 828: 827: 824: 819: 816: 813: 810: 807: 804: 803: 801: 796: 792: 788: 784: 781: 778: 774: 771: 767: 766: 764: 763: 762: 756:Security Rule 755: 750: 747: 744: 741: 738: 737: 733: 731: 729: 725: 723: 719: 717: 713: 711: 707: 705: 701: 699: 695: 693: 689: 685: 683: 682: 676: 674: 670: 665: 662: 660: 654: 650: 648: 643: 639: 637: 633: 629: 624: 617: 615: 613: 608: 605: 596: 594: 590: 587: 584: 579: 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