HIPAA Fact Sheet

What is HIPAA?

HIPAA is the Health Insurance Portability and Accountability Act of 1996. It sets standards for the maintenance and transmission of health information concerning individual patients including medical electronic data, security, electronic signatures, and code sets.

In a limited time frame, all health care organization must comply with uniform standards for billing systems, transactions, patient records privacy and access monitoring, security, and other issues.

Goals of HIPAA

Under HIPAA, the general goal is to improve the overall quality of health care through administration simplifications. More specifically:

• To improve the efficiency and effectiveness of the health care system by standardizing electronic data interchange (EDI) - exchange of any medical, billing, or other information.
• To protect the security and confidentiality of individual patient records.

What organizations does HIPAA target?

Health plans. After final regulations are passed (expected in the 4th quarter of 2000), health plans will have 36 months to comply.

Healthcare clearing houses. Any entity that processes nonstandard data elements of health information into standardized format. (Billing services, community health management information systems (IS), and value-added networks.)

Healthcare providers. Integrated delivery networks (IDNs), physicians, and hospitals. (24 months to comply).

What will HIPAA regulate?

1. Standards for code sets for health care data elements (terms, medical concepts, diagnoses, and procedures).
2. Security standards for health care information systems.
3. Standards for electronic signatures.
4. Standards for transmission of data elements for coordination of benefits and processing of claims.

How is HIPAA to be enforced?

As of now, there is no agency that regulates HIPAA compliance. General failure to comply incurs a penalty of up to $25,000 per person per year. Any wrongful disclosure of information can be fined up to $250,000 in fines and 10 years imprisonment.

Advantage of ResQNet solution

ResQNet’s solutions help healthcare organizations to achieve HIPAA objectives by leveraging existing clinical systems. It allows for easy, secure, monitored access to patient records. ResQNet is platform-independent, flexible, effective and cost-efficient. It merges seamlessly with existing clinical information systems, and implementation is quick.