Are there any physicians or groups exempted from the HIPAA privacy requirements?
Yes—in limited circumstances. A provider (or provider group) would be exempt from the HIPAA privacy requirements where (a) the provider 1) has less than 10 full time employees and 2) all claims transactions to all payors are made solely on paper (regardless of whether the provider participates in Medicare or not); OR (b) the provider 1) has a practice of any size and 2) all claims transactions to all payors are made solely on paper and 3) the practice does not participate in Medicare. Under the HIPAA privacy regulations, “a health care provider who transmits any health information in electronic form” is a “covered entity.” Thus, a practice that accepts or uses any electronic transactions (or uses a business associate to do so) must comply with the privacy regulations–whether the practice has more or less then 10 full time employees. Providers with 10 or more full time employees, which might otherwise wish to conduct all claims transactions solely on paper, will—if claims are submitted
Related Questions
- Are the HIPAA Privacy Rule Requirements applied in the same manner for self-funded employer groups as they are for fully insured employer groups?
- By establishing new waiver criteria and authorization requirements, hasn t the HIPAA Privacy Rule, in effect, modified the Common Rule?
- Are there any physicians or groups exempted from the HIPAA privacy requirements?
