HIPAA Administrative Simplification Statute & Rules

To improve the efficiency and effectiveness of the health care system, the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191, included Administrative Simplification provisions that required HHS to adopt national standards for electronic health care transactions and code sets, unique health identifiers, and security. At the same time, Congress recognized that advances in electronic technology could erode the privacy of health information. Consequently, Congress incorporated into HIPAA provisions that mandated the adoption of Federal privacy protections for individually identifiable health information.  HHS published a final Privacy Rule in December 2000, which was later modified in August 2002. This Rule set national standards for the protection of individually identifiable health information by three types of covered entities: health plans, health care clearinghouses, and health care providers who conduct the standard health care transactions electronically.  Compliance with the Privacy Rule was required as of April 14, 2003 (April 14, 2004, for small health plans). 

The HHS Office for Civil Rights administers and enforces the Privacy Rule.

Other HIPAA Administrative Simplification Rules are administered and enforced by the Centers for Medicare & Medicaid Services, and include:

• Transactions and Code Sets Standards
• Employer Identifier Standard
• National Provider Identifier Standard
• Security Rule

The Enforcement Rule provides standards for the enforcement of all the Administrative Simplification Rules.

All of the HIPAA Administrative Simplification Rules are located at 45 CFR Parts 160, 162, and 164.