HIPAA Compliance

Congress passed into law the Health Insurance Portability and Accountability Act of 1996 (HIPAA) with the goals of providing consumers with greater access to health care insurance, protecting the privacy of health care data, and promoting more standardization and efficiency in the health care industry. WellNet has been working to ensure compliance with the HIPAA legislation since its inception.

HIPAA regulations address the following key issues:

Portability -- Since 1996, HIPAA has protected health insurance coverage for workers and their families when they change or lose their jobs. If you need more information or need proof of coverage under a WellNet Healthcare health plan, call Member Services using the phone number on the back of your ID card.

Transaction Standards -- Many providers and health care companies
exchange information electronically (via computer). All covered entities, as defined by HIPAA, are required to use standard format, content and codes when submitting electronic transactions after October 16, 2003.

Privacy Standards -- HIPAA created new rights for individuals that provide more control over the use and disclosure of, and access to their own confidential information. The compliance deadline for all covered entities was April 14, 2003.

Security Standards -- All covered entities must take steps to assure the confidentiality, integrity, and availability of protected health information (PHI). Security requirements for Privacy were completed by the April compliance deadline. All covered entities must implement policies and procedures, both administrative and technical, to keep PHI secure and confidential, when it is PHI that is electronically transmitted, stored or manipulated by April 2005.

Unique Identifiers -- Another goal of HIPAA is to assign one identifying number to each provider, employer, health plan and individual. The National Employer ID will be used in transactions beginning in October 2003. Both the National Provider and Health Plan Identifier requirements have not been finalized.