Feeling Lucky? You Could Be One of the Nine Covered Entities Selected for HIPAA Compliance Review this Month

If you are a covered entity health plan or clearinghouse, you may be among the nine (un)lucky entities randomly chosen this month for review into compliance with HIPAA’s Administrative Simplification rules governing electronic transactions, code sets, and unique identifiers.  According to an FAQ published in March, the Centers for Medicare & Medicaid Services (CMS), acting on behalf of the U.S. Department of Health and Human Services (HHS) will select five health plans and four clearinghouses for this new compliance review. CMS has been actively investigating complaints (which can be filed here) related to the Administrative Simplification Rules for some time, publishing summary reports covering complaints submitted beginning in January of 2017. What will happen if any of these nine selected entities is determined to be non-compliant? According to CMS, If an organization isn’t compliant, HHS will work with the entity to resolve any issues. Corrective Action…

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