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Health plans and employers should review their HIPAA compliance procedures regularly.
The Department of Health and Human Services (HHS) National Standards Group (NSG) has issued new guidance through FAQs, providing important clarifications on HIPAA administrative simplification enforcement and compliance. Here are the key takeaways for HR professionals:
Enforcement: NSG enforces HIPAA’s administrative simplification rules by investigating complaints and conducting random compliance reviews. When violations are identified, NSG may require corrective actions. Failure to comply can result in civil monetary penalties.
Administrative Simplification Enforcement and Testing Tool (ASETT): The FAQs highlight the ASETT tool, which allows individuals to anonymously file complaints against HIPAA-covered entities for noncompliance with electronic transaction standards. It can also be used by entities to test their own electronic transactions or those of their trading partners to ensure compliance with HIPAA standards, including ASC X12 5010 standards. The tool streamlines compliance checks and helps prevent violations.
These updates serve as a reminder for health plans and employers to regularly review their HIPAA compliance procedures and use available tools, like ASETT, to ensure secure and compliant transactions.
Health plan sponsors and HR administrators should review these HHS clarifications and evaluate their current HIPAA compliance procedures as part of regular plan management. Consulting with a benefits partner about any identified compliance gaps is a recommended practice following new agency guidance.
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This article is for informational purposes only and is not intended as legal, tax, or benefits advice. Readers should not rely on this information for taking (or not taking) any action relating to employment, compliance, or benefits. Always consult with a qualified professional before making decisions based on this content.
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