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HIPAA Transactions and Code Sets

HIPAA TCS Enforcement

February 23, 2006: The AHA comments on the Enforcement rule: http://www.mc.vanderbilt.edu/root/sbworddocs/hipaatcs/Hospital_Highlights.pdf

February 16, 2006: The Final Rule on HIPAA Enforcement was published in the Federal Register. The regulation can be viewed at: http://a257.g.akamaitech.net/7/257/2422/01jan20061800/edocket.access.gpo.gov/2006/pdf/06-1376.pdf 

The Final Rule adopts the complete regulatory structure for implementing the civil money penalty authority of the Administrative Simplification part of HIPAA (SSA, section 1176), completing the structure begun when the Privacy Rule was issued in 2000 and expanded by the interim final procedural enforcement rules issued in 2003.  The Final Rule covers the enforcement process from its beginning, which will usually be a complaint or a compliance review, through its conclusion.  A complaint or compliance review may result in informal resolution, a finding of no violation, or a finding of violation.  If a finding of violation is made, a civil money penalty will be sought for the violation, which can be challenged by the covered entity through a formal hearing and appellate review process. These rules apply to covered entities that violate any of the rules implementing the Administrative Simplification provisions of HIPAA. This message was sent to you by the HIPAA Regulations listserv of the US Department of Health and Human Services

From CMS:   On April 18, 2005 the Department published a Notice of Proposed Rulemaking in the Federal Register which proposes the bases and procedures for imposing civil money penalties on covered entities that violate any of the HIPAA Administrative Simplification Rules.   Comments from the public are requested, and are due by June 17.  The NPRM is entitled:  Civil Money Penalties: Policies and Procedures for Investigations, Imposition of Penalties, and  Hearings.

From CMS:  On March 25, 2005 the Department published a Notice in the Federal Register detailing procedures for filing a complaint with the Department of non-compliance with the non-privacy HIPAA provisions, entitled: Procedures for Non-Privacy Administrative Simplification Complaints Under the Health Insurance Portability and Accountability Act of 1996.

Summary: This notice sets forth the procedures for filing with the Secretary of Health and Human Services a complaint of non-compliance by a covered entity with certain provisions of the administrative simplification rules under 45 CFR parts 160. 162, and 164. It also describes the procedures the Department employs to review the complaints. These procedures are intended to facilitate the investigation and resolution of these complaints.

Procedures for Non-Privacy Administrative Simplification Complaints Under the Health Insurance Portability and Accountability Act of 1996

AHA Notice of the Enforcement Rule . - In this document, the AHA outlines some of the key areas of concern for hospitals

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