 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.
|
