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What is HIPAA?

The Health Insurance Portability and Accountability Act of 1996. The first two sets of HIPAA regulations--the Electronic Transactions and the Privacy Regulations--are finalized and the compliance deadlines for small health plans are approaching quickly.

I'm an employer. Will HIPAA affect me?

Yes. If you provide health benefits to your employees, you are responsible for your group health plan's compliance with HIPAA and its regulations.

What is the first step I should take?

Determine whether your group health plan is a "covered entity" under HIPAA. Covered entities are defined as group health plans with more than 50 participants OR plans of any size that use a third-party administrator (TPA). Your plan is most likely a covered entity.

What are the Electronic Transactions Regulations?

They require covered entities to use standardized formats for transactions such as electronically processing claims, checking eligibility and paying premiums. The goal is to eliminate the 400plus formats that the industry is currently using. Oct. 16, 2003, is the compliance deadline for small health plans with less than $5 million per year. The deadline has passed for large plans.

What are the Privacy Regulations?

They require covered entities to: (1) follow strict rules on how they use and disclose health information; (2) respect new privacy rights granted to individuals; and (3) implement many administrative procedures designed to protect the privacy of health information. The compliance deadlines are April 14, 2003, for large health plans and April 14, 2004, for small plans. Failure to comply is punishable by up to $250,000 in fines and 10 years in prison.

Elizabeth O. Callahan, an attorney, is chair of Butzel Long's HIPAA Task Force. Butzel Long is a Silver-level member of the Detroit Regional Chamber.
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Article Details
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Title Annotation:Health Insurance Portability and Accountability Act of 1996; Health Care
Author:Callahan, Elizabeth O.
Article Type:Brief Article
Geographic Code:1USA
Date:Dec 1, 2002
Previous Article:Success story: Blue Cross Blue Shield of Michigan.
Next Article:Chamber tip: summary plan description.

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