![Department of Mental Health - LOGO [Graphic]](https://webarchive.library.unt.edu/eot2008/20090512062140im_/http://www.dmh.cahwnet.gov/images/dmh_logo.gif){kind=logo}
What's New | General HIPAA Information | Role of the Office of HIPAA Compliance |
Legal Preemption Analysis
What's New
(2.15 mb)
General HIPAA Information
The Health Insurance Portability and Accountability Act (HIPAA) was signed into federal law in 1996 (PL 104-191). The primary intent and purpose of this law was to protect health insurance coverage for workers and their families when they change or lose their jobs. It was recognized that this new protection would impose additional administrative burdens on health care providers, payers, and clearinghouses, and therefore, the law includes a section called Administrative Simplification. This section is specifically designed to reduce the administrative burden associated with the transfer of health information between organizations, and more generally to increase the efficiency and cost-effectiveness of the United States health care system. The approach is to accelerate the move from certain paper-based administrative and financial transactions to electronic transactions through the establishment of nationwide standards.
What are the Standards?
The standards are being developed by the federal Department of Health and Human Services (HHS). The proposed standards involve the following:
- Transactions: (Claims and Encounters; Enrollment; Claim Status; Eligibility; Payment/Remittance Advice; Referral Certification; Coordination of Benefits; Premium Payment; Claim Attachment; First Report of Injury)
- Code Sets: (Diseases; Injuries; Impairments; Procedures)
- Unique Identifiers: (Provider; Employer; Health Plan; Individual)
- Security: (Administrative Procedures; Physical Safeguards; Technical Security Services; Technical Security Mechanisms)
- Privacy: (Covered Information; Covered Entities; Disclosures)
The U.S. Department of Health and Human Services (DHHS) develops and publishes the rules pertaining to the implementation of HIPAA and standards to be used. All health care organizations impacted by HIPAA are required to comply with the standards within two years of their adoption (see the Calendar).
Role of the Office of HIPAA Compliance
The Department of Mental Health (DMH) is a provider of health care services and has been identified as a “covered entity” within the guidelines of the Health Insurance Portability and Accountability Act (HIPAA). The DMH, Office of HIPAA Compliance (OHC) is responsible for the successful implementation by DMH of all the final rules under HIPAA. The OHC works in partnership with the state hospitals and various DMH program areas to coordinate and manage the assessment and project plans for remediation necessary for compliance with the HIPAA final rules.
The DMH is responsible for
ensuring through partnerships the availability and
accessibility of mental health services and processing
mental health claims for Medi-Cal recipients. The
Department of Health Care Services (DHCS) is California’s
single agency for the Medi-Cal system. As such, DMH
is working collaboratively with DHCS as well as the
Department of Alcohol and Drug Programs (ADP) to ensure
uniformity in the process.