Links to the latest gap analysis
matrixes and checklists are included below under
Matrixes and Checklists. They are marked with
a star as shown here.
NOTE: Several of the listed documents require plug-ins for your browser. Links to the
plug-ins are as follows:
Contents
Business Transaction Testing Status
HIPAA Compliance Packet
Conference Call Minutes
Testing Status for Electronic Transactions
IHS HIPAA Compliant Forms
IHS HIPAA Compliant Policies and Procedures
IHS Notice of Privacy Practices
Health Insurance
Portability and Accountability Act of 1996
HIPAA Rules
Matrixes and Checklists
Other HIPAA Standards
HIPAA
Implementation Guides
HIPAA
PowerPoint Presentations
Other
Documents
IHS Business Associate Agreement
Health Insurance Portability and Accountability Act of 1996
Summary of Administrative Simplification Provisions
Standards for electronic health information transactions.
Within 18 months of enactment, the Secretary of HHS is required
to adopt standards from among those already approved by private
standards developing organizations for certain electronic health
transactions, including claims, enrollment, eligibility, payment,
and coordination of benefits. These standards also must address
the security of electronic health information systems.
Mandate on providers and health plans, and timetable.
Providers and health plans are required to use the standards for
the specified electronic transactions 24 months after they are
adopted. Plans and providers may comply directly, or may use a
health care clearinghouse. Certain health plans, in particular
workers compensation, are not covered.
Privacy. The Secretary is required to recommend privacy standards for health information to Congress 12 months after enactment. If Congress does not enact privacy legislation within 3 years of enactment, the Secretary shall promulgate privacy regulations for individually identifiable electronic health information.
Pre-emption of State Law. The bill supersedes state laws, except where the Secretary determines that the State law is necessary to prevent fraud and abuse, to ensure appropriate state regulation of insurance or health plans, addresses controlled substances, or for other purposes. If the Secretary promulgates privacy regulations, those regulations do not pre-empt state laws that impose more stringent requirements. These provisions do not limit a State's ability to require health plan reporting or audits.
Penalties. The bill imposes civil money penalties and prison for certain violations.
HIPAA Administrative Simplification Text
HIPAA Rules
Transaction and Code Sets
Final Rule published in the Federal Register on August 17, 2000
Preamble
| Regulation Text
Privacy Standards
Final Rule published in the Federal Register on December 28, 2000
Preamble
(3 parts) |
Regulation Text |
Guidance
Document
Security Standards
Final Rule was published in the Federal Register on February 20, 2003
Final Rule
National Provider Identifier
Proposed Rule published in the Federal Register on May 7, 1998
Comment period ended July 6, 1998
Proposed
Rule
National Employer Identifier
Proposed Rule published in the Federal Register on June 16, 1998
Comment period ended August 17, 1998
Proposed
Rule
Matrixes and Checklists
Transaction and Code Sets
IHS
Transaction Matrix | IHS Transaction Checklist |
Transactions and Code Sets Table |
RPMS Status
Privacy Standards
IHS
Privacy Matrix |
IHS Privacy Checklist |
Privacy Table
Security Standards
IHS Security Checklist
Other Standards Mandated by HIPAA
Retail Pharmacy Specifications
The HIPAA final standards for electronic health care transactions, and for code
sets, adopts the NCPDP
Telecommunication Standard Format, Version 5.1 and the NCPDP
Batch Standard, Version 1 Release 0 for pharmacy claims (see excerpt below).
Health plans,
health care clearinghouses and health care providers who utilize electronic
transactions will be required to use these standards beginning October
16, 2002.
162.920(a)(2) Retail pharmacy
specifications. The implementation specifications for all
retail pharmacy standards may be obtained from the National
Council for Prescription Drug Programs (NCPDP), 4201 North
24th Street, Suite 365, Phoenix, AZ, 85016; telephone
602-957-9105; and FAX 602-955-0749. It may also be obtained
through the Internet at http://www.ncpdp.org.
The implementation specifications are as follows:
(i) The Telecommunication Standard Implementation Guide,
Version 5 Release 1, September 1999, National Council for
Prescription Drug Programs, as referenced in §§162.1102,
162.1202, 162.1602, and 162.1802.
(ii) The Batch Standard Batch Implementation Guide,
Version 1 Release 0, February 1, 1996, National Council for
Prescription Drug Programs, as referenced in §§162.1102,
162.1202, 162.1602, and 162.1802.
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HIPAA Implementation Guides
Warning:
Many of these files are large.
Please be aware that they may require significant time to download
over a slow or busy connection.
If you intend to view these files more than once, you may want to
save the file locally. To save a file, right-click on its link
below and save the referenced file by choosing "Save Target As..."
or "Save link as..." or something similar, depending
on your browser. You may then
open the saved file to view it.
To view these files in Adobe's Portable Document Format (PDF), you
will need Adobe Acrobat Reader 3.0 or above. If you do not already
have Acrobat, click
here to download it.
Data
Element Dictionary (94 pages)
270/271:
Health Care Eligibility/Benefit Inquiry and Information Response (444 pages)
277/275:
Health Care Claim Request for Additional Information and Response (599
pages)
276/277:
Health Care Claim Status Request and Response (302 pages)
278:
Health Care Services Review — Request for Review and Response (468 pages)
820:
Payroll Deducted and Other Group Premium Payment for Insurance Products (166
pages)
834:
Benefit Enrollment and Maintenance (266 pages)
835:
Health Care Claim Payment/Advice (252 pages)
837:
Health Care Claim: Institutional (634 pages)
837:
Health Care Claim: Dental (436 pages)
837:
Health Care Claim: Professional (768 pages)
HIPAA PowerPoint Presentations
Some of the following PowerPoint slides use timed transitions, the rest require you to initiate the transitions using a mouse or keyboard action. You may make use of this presentation as is or change it as appropriate for your use.
Status of HIPAA Compliance in the Indian Health Service
PowerPoint presentation ( 3MB )
Adobe Acrobat PDF ( 1.5MB )
HTML document
Other Documents
The following flyer has been developed to provide an overview of the HIPAA
legislation and its potential impact on the Indian health community. This flyer
was last updated on August 17, 2001.
HIPAA Flyer | List of HIPAA Documents
Summary of April updates to the OCR website
OCR Press Release dated 04/11/2003
New updated FAQ's on CMS website
IHS Business Associate Agreement
IHS Business Associate Agreement PDF 341K
IHS Business Associate Agreement QA’s PDF 334K
Please email
questions or comments to HIPAA Web Contact.
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