Administrative Simplification (Title II, Subtitle F)
The administration simplification provision affects all health plans, health care clearinghouses, health providers who receive or submit any health information electronically and holders of individually identifiable health information. It has four sections, each of which has a standard associated with it. The standards are:
- Standard for Electronic Transactions (Transaction and Code Sets), 45 CFR Parts 160 and 162: This rule adopts standards for eight electronic transactions and for code sets to be used in those transactions. The standard mandates the manner in which claims data is sent from provider to payer and the information used to define the services rendered. This component had a compliance date of Oct. 16, 2003.
- Unique Health Identifiers, 45 CFR Part 142: This rule proposes a standard for a National Health Care Provider Identifier, National Employer Identifier and a National Health Plan Identifier and requirements concerning its use by a covered entity. This component has a compliance of 2006. The National Individual Identifier has been placed on hold due to citizen concerns.
- Security and Electronic Signature Standard, 45 CFR Part 142: This rule proposes standards for the security of individual health information and electronic signature use by covered entities. It applies to your computer systems and how you store and send medical data. This component has a compliance of 2006.
- Privacy of Individually Identifiable Health Information, 45 CFR Parts 160 and 164: This rule includes standards to protect the privacy of individually identifiable health information. This component had a compliance date of April 14, 2003.