• Compliance with HIPAA Electronic Health Care Transactions
  • October 21, 2003
  • Law Firm: Whiteford, Taylor & Preston L.L.P. - Baltimore Office
  • When the Health Insurance Portability and Accountability Act ("HIPAA") became law in 1996, one of its requirements was to establish national standards for electronic health care transactions and code sets. The original deadline for compliance with the national standards was October 16, 2002. That deadline, however, was extended one year to October 16, 2003 for all covered entities except for small health plans whose compliance deadline is already October 16, 2003.

    In order to qualify for the October 16, 2003 extension, if you are a covered entity, you must submit a compliance plan by October 15, 2002. If you are a covered entity and you do not submit a compliance plan by that date, then you must be compliant with the HIPAA Electronic Health Care Transaction and Code Set Standards (the "Standards") by October 16, 2002.

    In order to assist covered entities with compliance, a model compliance plan has been developed by the Department of Health and Human Services. For general information on how to complete the model compliance plan, you can go to www.cms.hhs.gov/hipaa/hipaa2/ASCAForm.asp. When you access this Website, you will find general information and instructions on how to complete the model compliance plan. You can submit the compliance plan electronically, and the Centers for Medicare and Medicaid Services ("CMS") will provide an on-line confirmation number as acknowledgment of your extension.

    For covered entities that complete the model compliance plan by paper, submission must be postmarked no later than October 15, 2002. For those who do not submit the plan electronically, no confirmation will be provided. Therefore, it would be prudent to mail the plan via a method that will provide you with confirmation of receipt.

    Covered entities that want to submit their own version of a compliance plan may do so provided that they submit by the October 15, 2002 deadline.

    Submission of the model compliance plan will guarantee the extension for compliance. However, compliance with the Standards should be included in your general HIPAA compliance plan.

    Remember, if you are a covered entity and you will not be compliant with the HIPAA Electronic Health Care Transaction and Code Set Standards by October 16, 2002, you must file a compliance plan. You can use the model compliance plan or submit your own compliance plan by the October 15, 2002 deadline. If you do not file a compliance plan by the October 15th deadline, you will be out of compliance with the Standards.