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Components of HIPAA

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Title I: Title I protects health insurance coverage for individuals who lose or change jobs. It also prohibits group health plans from denying coverage to individuals with specific diseases and pre-existing conditions, and from setting lifetime coverage limits. 

Title II: Title II directs the U.S. Department of Health and Human Services (HHS) to establish national standards for processing electronic healthcare transactions. It also requires healthcare organizations to implement secure electronic access to health data and to remain in compliance with privacy regulations set by HHS. 

Title III: Title III includes tax-related provisions and guidelines for medical care. 

Title IV: Title IV further defines health insurance reform, including provisions for individuals with pre-existing conditions and those seeking continued coverage. 

Title V: Title V includes provisions on company-owned life insurance and the treatment of those who lose their U.S. citizenship for income tax purposes. 

In healthcare circles, adhering to HIPAA Title II is what most people mean when they refer to HIPAA compliance. Also known as the Administrative Simplification Provisions, Title II includes the following HIPAA compliance requirements: 

National Provider Identifier: Each healthcare entity, including individuals, employers, health plans, and healthcare providers, must have a unique 10-digit national provider identifier number, or NPI. 

Transactions and Code Set Standard: Healthcare organizations must follow a standardized mechanism for electronic data interchange (EDI) to submit and process insurance claims.