The Health Insurance Portability and Accountability Act (HIPAA) was signed into federal law in 1996 (Public Law 104-191). HIPAA requires the Secretary of the Department of Health and Human Services to adopt standards for electronic transactions, including data elements, standard code sets, unique health identifiers, security safeguards and privacy standards.

HIPAA impacts every entity that exchanges claim and payment data such as health care providers, public and private health plans, vendors and clearinghouses. HIPAA Administrative Simplification (AS) standards significantly impact all providers conducting electronic transmission of medical data. Billing requirements, claim submission requirements and possibly even office procedures will need to change to comply with the standard requirements.

Medi-Cal continues to address HIPAA’s impact on existing billing and claim submission requirements. You will be notified on a continuous basis as billing instructions and submission requirements are implemented or changed. Prior to these phased changes, existing policy and billing requirements will remain in effect.

To ensure timely and effective communication of upcoming program changes, Medi-Cal plans a series of outreach efforts, utilizing a variety of methodologies. These methodologies include the existing provider bulletins, the Medi-Cal Web site and provider work groups and discussion groups. A new medium for you to access, e-mail discussion groups (Listserve), will be announced shortly. If you are interested in participating in any provider work group or discussion group activities, please contact the Provider Support Center at 1-800-541-5555. Please continue to check your provider bulletins and the Medi-Cal Web site for further updates.