Compliance / HIPAA

Health Insurance Portability and Accountability Act of 1996 (HIPAA)

The Health Insurance Portability and Accountability Act of 1996 called for many changes in health care. April 14, 2003 finalized federal regulations called HIPAA Privacy Regulations became effective. These regulations require that we take extra precautions to protect personal health information known as PHI. As HIPAA privacy regulations have a relatively recent effective date there may be some implementation challenges such as the need to obtain authorizations from member/patients/clients when disclosing PHI to an unauthorized third party or protecting PHI from casual onlookers who may be in our offices. We will all work through this together. Care1st Health Plan Arizona, Inc. has taken the necessary precautions to protect PHI and has developed policies and provided training on the issue to assist our staff.

HIPAA also involves Transaction Code Sets referred to as TCS provisions. These provisions require that health plans and health care payors follow requirements established by the federal government regarding health care billing and reimbursement. Soon you'll be hearing more about HIPAA security. We'll keep you informed of our HIPAA efforts through our Network Newsletter. If you have questions or concerns about HIPAA in your office visit the Department of Health Services, Office of Civil Rights website at www.hhs.gov/ocr/office or the CMS website at www.cms.hhs.gov/hipaa/hipaa2. Additionally, a HIPAA hotline has been established by CMS to help answer HIPAA administrative simplification questions 1-866-282-0659.

If you have further questions about HIPAA, please contact Care1st at (602) 778-8318 or call the Care1st Compliance Hotline at 1-877-837-6057 or visit the HIPAA website

HIPAA PRIVACY FORM

The HIPAA Privacy Form allows you to do several things including:

• Request Records
• Restrict Records
• Request an Amendment of Records
• Request a List of Plan Disclosures
• Submit a Privacy Compliant

HIPAA AUTHORIZATION FORM

The HIPAA Authorization Form allows you to:

• Give permission for someone to obtain a copy of your records

Download Literature:

• Privacy Request Form - AHCCCS
• Privacy Request Form - Medicare
• Privacy Authorization Form - AHCCCS
• Privacy Authorization Form - Medicare

HIPAA Resources

CMS Website
Answers to Frequently Asked Questions, links to other HIPAA sites, and information on the law, regulations, and enforcement are located here. Go to their website!

FREE CMS Fax Back Service
Do you need information on HIPAA but don’t have Internet access? CMS offers fax back service to businesses without Internet access. Many documents are available by calling 1-800-874-5894. Be sure to have your fax number ready when you call.

CMS E-mail Box
Send HIPAA administrative simplification questions here!

CMS HIPAA Hotline
1-866-282-0659, the hotline is to help answer HIPAA administrative simplification questions.

HHS’ Office for Civil Rights (Privacy)
The US Department of Health and Human Services (HHS) Office oversees the privacy requirements.