Exploring HIPAA and HITECH Act Definitions: Part 7

From now through November, HIPAA.com is providing a run through of HIPAA transaction & code set, privacy, and security definitions, along with relevant HITECH Act definitions pertaining to breach notification, securing of protected health information, and electronic health record (EHR) standards development and adoption. These definitions are key to understanding the referenced HIPAA and HITECH Act enabling regulations that are effective now and that will require compliance by covered entities and business associates now or in the months ahead, as indicated in HIPAA.com’s timeline. Each posting will contain three definitions, with a date reference to the Federal Register, Code of Federal Regulations (CFR), or statute, as appropriate.

Exploring HIPAA and HITECH Act Definitions:  Parts 6-10, include definitions from:

American Recovery and Reinvestment Act of 2009 (February 17, 2009, pp.228-229),

Health Information Technology for Economic and Clinical Health Act,

Title XIII—Health Information Technology,

Subtitle A—Promotion of Health Information Technology,

Section 13101—ONCHIT [Office of the National Coordinator for Health Information Technology]; Standards Development and Adoption,

Title XXX—Health Information Technology and Quality,

Section 3000—Definitions (also designated as 42 USC 300jj).

Health Information

Has the meaning given such term in section 1171(4) of the Social Security Act:

“Any information, whether oral or recorded in any form or medium, that—

(A) is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse; and

(B) relates to the past, present, or future physical or mental health or condition of an individual, the provision of health care to an individual, or the past, present, or future payment for the provision of health care to an individual.”

Health Information Technology

Hardware, software, integrated technologies or related licenses, intellectual property, upgrades, or packaged solutions sold as services that are designed for or support the use by health care entities or patients for the electronic creation, maintenance, access, or exchange of health information.

Health Plan

Has the meaning given such term in section 1171(5) of the Social Security Act:

“An individual or group plan that provides, or pays the cost of, medical care (as such term is defined in section 2791 of the Public Health Service Act.)  Such term includes the following, and any combination thereof:

(A) A group health plan (as defined in section 2791(a) of the Public Health Service Act), but only if the plan—

  1. Has 50 or more participants (as defined in section 3(7) of the Employee Retirement Income Security Act of 1974); or
  2. Is administered by an entity other than the employer who established and maintains the plan.

(B) A health insurance issuer (as defined in section 2791(b) of the Public Health Service Act).

(C) A health maintenance organization (as defined in section 2791(b) of the Public Health Service Act).

(D) Part A, B, or C of the Medicare program under title XVIII.

(E) The Medicaid program under title XIX.

(F) A Medicare supplemental policy (as defined in section 1882(g)(1)).

(G) A long-term care policy, including a nursing home fixed indemnity policy (unless the Secretary [of HHS] determines that such a policy does not provide sufficiently comprehensive coverage of a benefit so that the policy should be treated as a health plan).

(H) An employee welfare benefit plan or any other arrangement which is established or maintained for the purpose of offering or providing health benefits to the employees of 2 or more employers.

(I)  The health care program for active military personnel under title 10, United States Code.

(J)  The veterans health care program under chapter 17 of title 38, United States Code.

(K) The Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), as defined in section 1072(4) of title 10, United States Code.

(L)  The Indian health service program under the Indian Health Care Improvement Act (25 U.S.C. 1601 et seq.).

(M) The Federal Employees Health Benefit Plan under chapter 89 of title 5, United State Code.”

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