Care1st - Home Page
OUR NETWORK
Primary Care Physicians
Ancillary Providers
Specialists
Dentists
OB/GYN

  
Archive Section
Blast Faxes
Compliance / HIPAA
Contingency Plan
Dental
Disease Management
Forms
Frequently Ask Questions
Industry / County Links
Medical Records
Patient Safety
Formulary
Preventive Health
Prior Auth Reference Grid
Login
Manual
Mailings and Newsletters
   Compliance / HIPAA


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/hipaa.html 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 Resources

Deficit Reduction Act (DRA)
Care1st providers must train their staff on the following aspects of the Federal False Claims Act provisions:

  • The False Claims Act, Including Examples of False Claims and Remedies
  • Federal Whistleblower Protections
  • AHCCCS - Prohibited Acts and Remedies

    For training materials, please visit the following website:
    www.ahcccs.state.az.us/PlansProviders/DRATraining/DRATraining/index.htm

    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.


  •  
    Home | Providers | Members | Health Plans | About Us | News & Events | Site Map | Contact Us

    Services funded in part by the State of Arizona • Servicios fundados en parte por el Estado de Arizona 

    Please note that all materials found on this website are also available in hard copy by contacting Member Services at 602-778-1800 or 1-866-560-4042 or by e-mailing us through the link located in this website.

    Copyright © 2003 - 2008 Care1st Health Plan Arizona, Inc.
    Conditions of Use and Disclaimer