[ Monday, January 13, 2014 ]
Transactions and Code Sets News: Health Plans must certify to compliance with HIPAA transaction and code set rules.
Jeff [1:31 PM]
I saw this news last week but thought it was simply HHS saying health plans are covered by HIPAA; which they are, naturally. Health plans are covered entities, and must comply with the Privacy Rule and Security Rule.
But the point is that they must all use standard transactions. This goes back to the earliest part of HIPAA, based on trying to standardize electronic data interchange transactions in the healthcare industry, and the drafting of specific forms, data sets, and formats to be used in every payment transaction, for example. Get rid of the legacy systems and individual payor formats and use standard documentation. It's interesting to see this come up again. Frankly, everyone in the health industry ought to be using standard formats, and to the extend a lot of smaller players (small health plans specifically) aren't doing so, then either we don't need the standards or we aren't enforcing the requirements like we should be.
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