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HIPAA Compliance
NDCHealth's Participation In The Standards Process
We feel that participation in the regulatory process is necessary in order to
simplify health care business processes and models, in achieving standardization,
and in protecting the confidentiality of information as it is exchanged and
stored. NDCHealth has had a long-standing history of participation and support
of standards programs. We have been applying these principles in our systems
design and implementations for more than 20 years. We participate in and have
had representation in organizations such as NCPDP, DISA, ASC X12, WEDI, AFEHCT,
and UN/EDIFACT/CEFACT.
Administrative simplification cannot be achieved through technology and standards
alone, but is a combination of business processes, technology, and experience
in applying practices and tools that will culminate in administrative simplification.
How Does HIPAA Fit?
HIPAA is the acronym for the Health Insurance Portability and Accountability
Act that was signed into law on August 21, 1996, Public Law 104-191. This law
impacts all areas of the health care industry and was designed to provide insurance
portability, to improve the efficiency of health care by standardizing the exchange
of administrative and financial data, and to protect the privacy, confidentiality
and security of health care information.
Health Insurance Portability and Accountability Act of 1996 (P.L. 104-191)
The law is designed to improve portability and continuity of health insurance
coverage, to combat waste, fraud and abuse in health insurance and health care
delivery, to promote the use of medical savings accounts, to improve access
to long-term care services and coverage, to simplify administration of health
insurance, and for other purposes. [H.R. 3103]
NDCHealth supports the HIPAA objectives and is proactively enhancing our existing
HIPAA compliance initiatives on behalf of our customers.
Administrative Simplification
The intent is to simplify administrative and financial data transactions by
defining new codes and unique identifiers and by standardizing transactions
and EDI formats. Hospitals, physician offices, home health agencies, nursing
homes, affiliated providers, payers, employers, data services, and regulatory
agencies are impacted by HIPAA.
The complete text of the proposed and finalized rules, along with comments,
is available at: http://aspe.hhs.gov/admnsimp
Transaction Sets impacted:
Health Care claim or encounter information
Enrollment and disenrollment in a health plan
Eligibility for a health plan
Claim payment and remittance advice
Premium payments
Health Care claim status
Referral certification and authorization
Health Care claim attachment
First report of injury
Security
Reasonable and appropriate administrative, technical and physical safeguards
are to guard the integrity and confidentiality of information, protect against
reasonably anticipated threats or hazards to security and integrity of the information
and unauthorized uses or disclosures of the information, and to maintain standards
of compliance by officers and employees of applicable entities. For more information
on security, please reference: http://aspe.hhs.gov/admnsimp
NDCHealth, in coordination and cooperation with its trading partners, works
to provide as secure an environment as is reasonably and technically possible.
NDCHealth's HIPAA Initiative:
NDCHealth has established a Corporate HIPAA Office to: "Track and provide
coordination, encouragement, education, communication, and legal interface for
all HIPAA activities throughout NDCHealth. Monitor and verify that HIPAA efforts
for readiness and compliance are proceeding accordingly within NDCHealth responsible
organizations."
The HIPAA Office:
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Provides
oversight of all HIPAA activities throughout NDCHealth
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Facilitates
coordination of the various HIPAA activities across the company
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Identifies
areas for concentration
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Provides
a center of expertise
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Communicates
HIPAA status and activities to third parties
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Coordinates
compliance activities
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Responds
to inquiries
For additional information,
see http://www.hipaacomply.com
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