Table 10. Meaning of Short Violation Names
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Short
Violation Name
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Long
Violation Name
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700 - Part 7 Provisions
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700.1 - HIPAA Violations
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H1 - Impermissible preexisting condition exclusion
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HIPAA-H1 (Preex)-Look-back
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701(a)(1) - 6-Month look-back violation
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HIPAA-H1 (Preex)-Genetic
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701(a)(1) [using 701(b)(1) definition] - Preex on
genetic information
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HIPAA-H1 (Preex)-Look-fwd
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701(a)(2) - 12 Month (or 18 month) look-forward
violation
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HIPAA-H1 (Preex)-No offset
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701(a)(3) [using 701(c) definition] - Failure to
offset
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HIPAA-H1 (Preex)-Newborns
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701(d)(1) - Impermissible preex on newborns
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HIPAA-H1 (Preex)-Adoption
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701(d)(2) - Impermissible preex on children adopted
or placed for
adoption
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HIPAA-H1 (Preex)-Pregnancy
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701(d)(3) - Pregnancy preex
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HIPAA-H1 (Preex)-Gen. notices
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29CFR 2590.701-3(c) - Failure to give adequate
generalized notices
of preex
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HIPAA-H1 (Preex)-Ind. notices
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29CFR 2590.701-5(d) - Failure to give adequate
individualized notices
of preex
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HIPAA-H1 (Preex)-Other
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Other - Impermissible preex
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H2 - Failure to Provide Certificates
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701(e)(1)(A)(i) - Automatically upon loss of coverage (COBRA covered
plan)
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HIPAA-H2 (Certif)-Auto-C-P
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701(e)(1)(A)(i) - By Plan (COBRA Covered)
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HIPAA-H2 (Certif)-Auto-C-I
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701(e)(1)(A)(i) - By Issuer only pursuant to
agreement (COBRA
Covered)
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701(e)(1)(A)(ii) - Automatically upon loss of coverage (Non COBRA
covered)
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HIPAA-H2 (Certif)-Auto-NC-P
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701(e)(1)(A)(ii) - By Plan (Non COBRA Covered)
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HIPAA-H2 (Certif)-Auto-NC-I
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701(e)(1)(A)(ii) - By Issuer only pursuant to
agreement (Non COBRA
Covered)
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701(e)(1)(A)(iii) - Upon request
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HIPAA-H2 (Certif)-Req-P
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701(e)(1)(A)(iii) - By Plan (Upon Request)
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HIPAA-H2 (Certif)-Req-I
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701(e)(1)(A)(iii) - By Issuer only pursuant to
agreement (Upon
Request)
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29 CFR 2590.701 - 5(a)(2) - Within required time frames
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HIPAA-H2 (Certif)-Time-P
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29 CFR 2590.701 - 5(a)(2) - By Plan (W/In Req'd
Timeframes)
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HIPAA-H2 (Certif)-Time-I
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29 CFR 2590.701 - 5(a)(2) - By Issuer with agreement
(W/In Req'd Timeframes)
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HIPAA-H2 (Certif)-Other
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Other - Failure to Provide Certificates
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H3 - Special Enrollment Violation
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HIPAA-H3 (Sp Enroll)-Cov loss
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701(f)(1) - Failure to allow special enrollment
upon loss of other coverage
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HIPAA-H3 (Sp Enroll)-Dependent
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701(f)(2) - Failure to allow dependant special
enrollment
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HIPAA-H3 (Sp Enroll)-No notice
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29 CFR 2590.701-6(c) - Failure to give notice
of special enrollment rights
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HIPAA-H3 (Sp Enroll)-Other
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Other - Special Enrollment Violation
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H4 - Nondiscrimination Violation
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HIPAA-H4 (Non-dscrm)-Ncfmnt
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702(a) - Nonconfinement clause that delays
eligibility
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HIPAA-H4 (Non-dscrm)-Other elig
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702(a) - Other violation of eligibility
discrimination provision
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HIPAA-H4 (Non-dscrm)-Ncfmnt-prem
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702(b) - Nonconfinement clause that raises
premiums
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HIPAA-H4 (Non-dscrm)-Other prem
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702(b) - Other violation of premium
discrimination provision
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HIPAA-H4 (Non-dscrm)-Other
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Other - Nondiscrimination Violation
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HIPAA-H5 (HMO Affil Period)
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H5 - 701(g) - HMO Affiliation Period Violation
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HIPAA-H6 (Multi No renew)
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H6 - 703 - MEWA or Multiemployer Plan Failure to
Provide Guaranteed
Renewability
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700.2 - Mental Health Parity Act Violations
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Not Subject to Mental Health Parity Act
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Mental Health Parity Act Violation
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MHPA-M1 (Life limit)
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M1 - 712(a)(1) - Lifetime Dollar Limit
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MHPA-M2 (Constr life Limit)
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M2 - 712(a)(1) - Constructive (Straight math)
Lifetime Dollar Limit
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MHPA-M3 (Annual limit)
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M3 - 712(a)(2) - Annual Dollar Limit
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MHPA-M4 (Constr annual Lim)
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M4 - 712(a)(2) - Constructive (Straight math)
Annual Dollar Limit
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MHPA-M5 (Subst abuse offset)
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M5 - 29 CFR 2590.712(b)(4) - Substance Abuse
Offsets Mental Health
Limit
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MHPA-M6 (Other)
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M6 - Other
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700.3 - Newborns’ and Mothers’ Health Protection Act Violations
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Not Subject to Newborns’ and Mothers’ Health Protection Act
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Newborns’ and Mothers’ Health Protection Act Violations
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NMHPA-N1 (48/96 hour rule)
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N1 - 711(a)(1)(A) - Violation of 48/96 Hour Stay
Rule
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NMHPA-N2 (Plan authoriz)
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N2 - 711(a)(1)(B) - Provider Required to Obtain
Authorization From Plan
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NMHPA-N3 (Doc/mom incent)
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N3 - 711(b) - Incentives to Mothers or Doctors
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NMHPA-N4 (Notice viol)
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N4 - 711(d) - Notice Violation
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NMHPA-N5 (Other)
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N5 - Other
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700.4 - Women's Health and Cancer Rights Act Violations
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Not Subject to Women's Health and Cancer Rights Act
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Women's Health and Cancer Rights Act Violation
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WHCRA-W1 (Missing cov)
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W1 - 713(a) - Not Providing the Three Required
Coverages
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WHCRA-W2 (Annual notice)
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W2 - 713(a) - Annual Enrollment Notice Violation
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WHCRA-W3 (One-time notice)
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W3 - 713(b) - One-Time Notice Violation
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WHCRA-W4 (Incentive prob)
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W4 - 713(c) - Incentive Problem
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WHCRA-W5 (Other)
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W5 - Other
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