- The Administrative Simplification provisions of HIPAA apply to the adoption of electronic transaction standards and operating rules for use in the health care industry. Information about the HIPAA regulations regarding standards and operating rules can be found at https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/HIPAA-ACA/index.html.
- Before implementation of a new version of a standard, end to end testing should be conducted with vendor systems and between trading partners to ensure changes have been accommodated.
- Additional information is available on testing, and the full cost on any of the X12 transactions. ASETT is the HHS compliance tool to enable testing and complaint filing for all X12 and NCPDP® transactions.
- For a description of the functionality of each transaction, visit the X12 website. Click on a transaction set name to toggle the display of the purpose and scope of that transaction set.
- The HL7 FHIR Consumer Directed Payer Data Exchange (Carin IG for BlueButton) STU 1 was recommended for use in the May 2020 CMS Interoperability and Patient Access final rule to enable the Patient Access API policy, specifically to support patients access to data held by their payers, enabling them to request data to be sent to a third party app.
- STU 2 of the HL7 FHIR Consumer Directed Payer Data Exchange (Carin IG for BlueButton) will include the ability to exchange dental claim information.
- All covered entities and their business associates are required to comply with the HIPAA Privacy and Security Rules. Health and Human Services has partnered with the Office of the National Coordinator and the National Institutes of Standards and Technology to publish comprehensive guidance for Security specific to electronic protected health information. A self-assessment tool kit is available to support integrating privacy and security into practices.