FREQUENTLY ASKED QUESTIONS



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An Introduction to HIPAA, the Health Insurance  Portability and Accountability Act

Which of the HIPAA regulations will have the most  impact on healthcare?

What is the purpose of the HIPAA Security and  Electronic Signature standards?

Why are new Security and Electronic Signature  standards needed?

What is the electronic signature standard?

How will the standards to protect individual health  information be implemented?

Who must comply?

Who must comply with the Electronic Signature  standard?

Do security requirements apply only to the  transactions adopted under HIPAA?

Is it mandatory to use an electronic signature?

Do the Security Standards apply to paper  documents?

Does the Security Standard require use of specific  technologies?

How will smaller providers be affected?

What are the required timelines for achieving compliance with HIPAA regulations?

What benefits do the new HIPAA regulations  provide to healthcare organizations?

What is the tentative schedule for publication of  HIPAA Administrative Simplification Regulations?

 

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An Introduction to HIPAA, the Health Insurance Portability and Accountability Act

Put off and delayed, some might even say ignored due  to the healthcare's recent focus on Y2K, the Health  Insurance Portability and Accountability Act or HIPAA,  has now achieved critical status for the industry. Once  U.S. policy makers begin introducing final HIPAA regulations, most healthcare organizations will have twenty-four months to comply with rules that will  fundamentally affect many of the ways healthcare  conducts its business.

The Health Insurance Portability and Accountability Act  or HIPAA will:

Passed in 1996, HIPAA is designed to protect  confidential healthcare information through improved  security standards and federal privacy legislation. It  defines requirements for storing patient information  before, during and after electronic transmission. It also identifies compliance guidelines for critical business  tasks such as risk analysis, awareness training, audit  trail, disaster recovery plans and information access  control and encryption.

These security standards for information access control  and encryption may have the most significant impact on  how the industry conducts its business.

Complying with Security Standards

There are more than sixty-eight information security  conditions in three areas that must be met to ensure  compliance with HIPAA. These areas are:

Cost Implications for Healthcare

Many experts in the industry estimate that the impact and cost of HIPAA and the organizational changes required  for implementation will significantly dwarf the expense of  preparing for Y2K. Additionally, unlike one-time Year  2000 preparations, information security will become an  annual IT budgetary cost for training, evaluating,  inspecting and updating security systems and policies.

Additionally, failure to achieve compliance with  HIPAA could find hospital executives, physicians  and others facing fines of up to $25,000. Certain  criminal violations could cost individuals and  organizations $250,000 and up to 10 years in jail!

Final costs for compliance will largely depend on  whether an organization's current information systems  are capable of accommodating the regulation's  encryption and standardization requirements. HIPAA  may require system replacements if they are unable to manage the new functional requirements. Rules  regarding the development, verification and security of  electronic signatures may prove particularly problematic for some existing systems.

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Which of the HIPAA regulations will have the most  impact on healthcare?

At the core of the new regulations are requirements to  systemize, expedite and protect the electronic transfer  of healthcare information. These include:

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What is the purpose of the HIPAA Security and Electronic Signature standards?

The new standards are being developed to protect the confidentiality, integrity and availability of individual health information.

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Why are new Security and Electronic Signature standards needed?

There were no existing standards that provided comprehensive and uniform protection of individual health information. HIPAA's new security standards will permit appropriate access and use of an individual's health information by health care providers, clearinghouses, and health plans while providing appropriate safeguards against misuse and dissemination. HIPAA will also mandate a new electronic signature standard for healthcare organizations when an electronic signature is employed in the transmission of a HIPAA standard transaction.

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What is the electronic signature standard?

The Electronic Signature Standard will provide a reliable method of assuring message integrity, user authentication and non-repudiation.

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How will the standards to protect individual health information be implemented?

The standards require safeguards for the physical storage and maintenance, transmission, and access to individual health information. Implementation will depend upon the individual organization, its existing technology and the risks to and vulnerabilities of the information it 
must protect.

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Who must comply?

Covered entities must comply with HIPAA.  Covered entity means:
1.  A health plan.
2.  A health care clearinghouse.
3.  A health care provider who transmits any health information in electronic form in connection with a transaction covered by the HIPAA transactions regulation.
(HHS Regulations Definitions  160.103)

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Who must comply with the Electronic Signature standard?

Any healthcare provider, health care clearinghouse, or health plan that employs an electronic signature in the transmission of one of the transactions adopted under HIPAA. The electronic signature standard applies only to the transactions adopted under HIPAA.

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Do security requirements apply only to the transactions adopted under HIPAA?

No. The security standard applies to all individual health information that is maintained or transmitted. This is much broader than the specific transactions currently defined in the law.

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Is it mandatory to use an electronic signature?

No. At this time, none of the transactions adopted under HIPAA requires an electronic signature.

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Do the Security Standards apply to paper documents?

The most significant change from the proposed regulations is that they now extend to all individual identifiable health information in the hands of covered entities, regardless of whether the information is or has been in electronic form.  This includes purely paper records and oral communications.

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Does the Security Standard require use of specific technologies?

No. The Security Standard is "technologically neutral" in order to facilitate use of the latest and most promising technologies that meet the needs of different healthcare organizations. The security standard is a compendium of security requirements that must be satisfied. While all organizations will be required to meet the basic requirements, particular solutions will likely vary based upon organizational size and complexity.

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How will smaller providers be affected?

The proposed security standard does not require extraordinary measures. It involves taking actions that assure the security of the information to be protected. The standard does not dictate specific technologies.  The requirements of the standard may be implemented  in a number of ways, depending upon the security needs and technologies in place at each business and upon  agreements among businesses that work together.

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What are the required timelines for achieving compliance with HIPAA regulations?

According to HHS rules, the implementation deadline will be two years and two months after the final HIPAA regulations are released.

It is not yet certain as to how the privacy regulations will ultimately be interpreted and enforced by the Health Care Financing Administration.

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What benefits do the new HIPAA regulations provide to healthcare organizations?

We can identify three important potential benefits.

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What is the tentative schedule for publication of HIPAA Administrative Simplification Regulations?

To view the most recent schedule as published by the U.S. Department of Health and Human Services,


Standards are required to be implemented within 2 years of the effective date of the final rule; generally 60 days after publication of the rule. However, the effective date for the National Provider Identifier is planned to be no earlier than 7/2000, to give the Department enough  time to develop the system for implementing the identifier.

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