HIPAA Principles and Provisions

Course Description:

HIPAA Principles and Provisions examines the genesis of  many of the legislation's provisions in the National Uniform Billing Committee and in earlier attempts to impose healthcare reform. It considers the changes the legislation made in the rules applicable to group and individual health insurance plans with respect to the imposition of pre-existing conditions exclusions and the insurer’s ability to decline to offer coverage, changes that provided a conceptual basis for the more significant changes implemented under the Affordable Care Act.

Archer medical savings accounts (MSAs) - the pilot program that acted as a precursor to health savings accounts (HSAs) - are explained. The important MSA issues relating to eligibility, permissible contributions and the tax treatment of contributions and distributions are examined.

In addition to a discussion of HIPAA's early attempt to change some of the traditional health insurance underwriting rules, the simplification of healthcare administration contained in Title II of the legislation is also examined. In so doing, HIPAA's requirements concerning electronic transactions, security, national provider identifiers (NPI) and privacy of protected health information are examined.

Learning Objectives:

Upon successful completion of this course, participants will be able to:

·        Recognize the early efforts at healthcare reform;

·         Identify the contribution and other limits applicable to medical savings accounts;

·         Describe the requirements for medical savings account eligibility;

·         Apply the tax rules to medical savings account contributions and distributions;

·        Identify the entities directly impacted by the HIPAA's administrative simplification provisions; and

·         Recognize the security and privacy regulations imposed by HIPAA regulations on personal health information.