Noel and Max, You are both correct. The definition of a covered entity related to providers is as follows (at 160.103): Covered Entity means:... a health care provider who transmits any health information in electronic form in connection with a transaction covered by this subchapter.
This definition is in Part 160 of the regulation - the general regulatory provisions. Unless HHS changes this part of the regulation, providers that don't transmit standard transactions by electronic means (or have someone do it on their behalf) are not covered by any of the administrative simplification regulations - transactions, privacy, etc. The risk for such providers, who are bound to be a very small minority, is that if health information is not kept private, and it damages an individual, the individual may sue under general state law and use HIPAA as an industry standard of care that the provider failed to follow. Whether this will hold result in liability is an open question. Leah Hole-Curry Fox Systems, Inc. 602-708-1045 >>> "Max Bumbalough" <[EMAIL PROTECTED]> 03/18/02 10:25 AM >>> Noel, I asked that question at the SNIP Conference in Chicago early last year and was told that if a healthcare provider does NOT electronically transmit any of the covered transactions, then they will not have to comply with the Privacy & Security Regulations. However, a HC Provider will not be excluded from complying with the Privacy & Security rules by merely using a billing service/company to transmit electronic transmissions. Has anyone else heard anything different? Max Bumbalough HIPAA Consultant GovConnect, Inc. (800)565-4873 x230 [EMAIL PROTECTED] >From: Noel Chang <[EMAIL PROTECTED]> >To: [EMAIL PROTECTED] >Subject: Covered entities >Date: Mon, 18 Mar 2002 10:44:45 -0600 > >Has anyone seen any further clarification from DHHS on who must comply >with the Privacy Rule? > >The way I interpret the final rule published in December of 2000, and >the guidelines published in July of 2001, the only health care providers >that must comply are those who electronically conduct one or more of the >ten covered transactions. I have encountered a specialist who does not >accept any insurance, they are a cash only operation. As such they do >not file any claims or deal with eligibility, etc. By my reading they >would appear to not be a covered entity and therefore are not required >to comply with the Privacy Rule. > >I keep seeing information from various sources (not DHHS or OCR, >however) that make very broad statements such as "HIPAA applies to >everyone" or "there are no HIPPAA free records". I can understand what >they mean by these statements in certain context but I think they are a >little too broad and misleading. Does anyone else agree that a doctor's >office who is not electronically conducting a covered transaction is >therefore not a covered entity for the purposes of the Privacy Rule? If >you do not agree, can you cite where is the requirement that such an >office comply with the Privacy Rule? > >Thanks, > >Noel Chang > > >********************************************************************** >To be removed from this list, go to: >http://snip.wedi.org/unsubscribe.cfm?list=privacy >and enter your email address. _________________________________________________________________ Get your FREE download of MSN Explorer at http://explorer.msn.com/intl.asp. ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=privacy and enter your email address. ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=privacy and enter your email address.
