Could Obamacare Make All Providers Covered Entities? | HIPAA Compliance

As you know, only those providers that transmit one or more of the standard transactions in electronic format are covered entities that must comply with HIPAA. See my August 16, 2011, blog post. Some providers, therefore, simply have decided not to do so—that is, not to bill electronically—so as to avoid having to comply with HIPAA. (Note that using a billing service that transmits one or more of the standard transactions in electronic format qualifies as the provider doing so.)

If the U.S. Supreme Court does not strike down the Affordable Care Act (a misnamed law if there ever was one!) in whole or in part—it could strike down the individual mandate and leave other parts of the law intact—this method of avoiding having to comply with HIPAA may evaporate. Section 1104 of that Act amends Section 1862(a) of the Social Security Act to require that all payments to providers and suppliers be electronic. This law would do away with the current exemption under which small providers, primarily single providers, could operate entirely in a paper format.

Even if the Supreme Court strikes down Obamacare in its entirety, don’t be surprised if this provision becomes law under some other attempt to regulate the health care industry.

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