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New HIPAA Administrative Simplification Fundamentals Fact Sheet

The Centers for Medicare & Medicaid Services’ (CMS) National Standards Group (NSG), on behalf of the Department of Health and Human Services (HHS), would like to highlight its new HIPAA Administrative Simplification Fundamentals Fact Sheet (PDF) [ https://www.cms.gov/files/document/hipaa-admin-simp-fundamentals-fact-sheet.pdf ], located on the HIPAA and Administrative Simplification webpage [ https://www.cms.gov/priorities/key-initiatives/burden-reduction/administrative-simplification/hipaa ] of the Administrative Simplification website [ https://www.cms.gov/priorities/key-initiatives/burden-reduction/administrative-simplification ]. The new resource provides an overview of Administrative Simplification, its purpose, goals, and how the health care industry benefits from it.

Administrative Simplification requirements, which were authorized by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and subsequent legislation, govern how providers, health plans, and clearinghouses—otherwise known as HIPAA covered entities [ https://www.cms.gov/priorities/key-initiatives/burden-reduction/administrative-simplification/hipaa/covered-entities ]—handle electronic administrative transactions and set standards for transmitting health information.

When electronic administrative tasks between players in the health care industry are conducted the same way across all covered entities, the industry can automate many of its billing and payment processes, which reduces time spent on administrative tasks and saves health care dollars.


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