HIPAA - Health Insurance Portability and Accountability Act - Effective April 14, 2003 for most entities and April 14, 2004 for small health plans. A small health plan is described as having less than five million in annual receipts.

In the event a plan is not compliant, it may continue its operations and cash flow provided that a good faith, and ongoing effort is being made to become compliant and can be reasonably demonstrated.

• For electronic transaction and code sets rule, the deadline was October 16, 2003.
• Security standards must be met by all covered entities by April 21, 2005.

Below is a list of frequently asked questions:

• What does the Act do?
• Who is covered by the Act?
• What is the "average" health care provider required to do?
• Can a health plan network communicate products and services of participating providers or its own products and services?
• Can care providers and pharmacists mail reminders to patient's homes?
• When is a written and signed authorization required (such as for marketing) versus a voluntary consent?
• Can health plans communicate about health related products or services to enrollees that add value but are not part of the plan?
• Can a doctor or pharmacy be paid to make/send a prescription or appointment reminder without prior authorization?
• Can telemarketers obtain and use my health care information to contact me about goods and services?
• Do health care providers have to mail out notices in connection with changes in its notice policy?
• Can communications be issued to individuals having a specific condition to make them aware of particular products and services for that condition?
• Are hospitals or other care providers required to provide their notices to patients treated under emergency conditions?
• Can information such as name, address, and social security number be disclosed for public health purposes?
• Can the notices of care providers be provided with or as part of other mailings or distributions?
• What is a business associate under the Act?
• When is a business associate agreement needed?
• When is a data sharing agreement needed?
• Is a software vendor considered to be a business associate?
• What safeguards are needed for such practices as posting medical charts?
• Can I use a log book or other form to acknowledge receipt of notice?
• May care providers use sign in sheets?
• Does the authorization have to contain an expiration date?
• Can an email, facsimile, or copy suffice as a signed authorization?
• When is an authorization required from a patient before a provider of a health plan can engage in marketing to that individual?
• Can information be disclosed in an effort to collect payment?
• Is the notice required to be posted at the care facility?

The information contained in this Special Edition of WK Today does not reflect the views or opinions of Ward/Kraft, Inc. and are merely provided for informational purposes only. Ward/Kraft, Inc. encourages you to seek the advice of counsel for each situation that you may encounter to make sure you are in compliance with the Act. No representations or warranties are made with the respect to the information contained herein, its accuracy, or its fitness for a particular purpose.
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• Tuesday, April 20th @ 9:00 am CST
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