1. What are the four parts of the administrative simplification requirements of HIPAA?
• Electronic transactions and code sets standards requirements
• Privacy requirements
• Security requirements
• National identifier requirements
2. Name 3 factors used to determine whether you need to comply with HIPAA.

a. Whether the health plan is self-insured or fully insured
b. Whether the plan sponsor receives PHI or SHI
c. How the plan sponsor utilizes SHI.

3. What are the three categories of entities affected by HIPAA Medical Privacy Regulations?
• Health Care Providers: Any provider of medical or other health services, or supplies, who transmits any health information in electronic form in connection with a transaction for which standard requirements have been adopted.

• Health Plans: Any individual or group plan that provides or pays the cost of health care.

• Health Care Clearinghouses: A public or private entity that transforms health care transactions from one format to another.
4. What would Business Associates of covered entities consist of as it pertains to HIPAA’s regulation?

HIPAA defines a business associate as an individual or corporate "person" that:
• performs on behalf of the covered entity any function or activity involving the use or disclosure of protected health information (PHI); and

• is not a member of the covered entity's workforce.

5. Who is covered by the Privacy Rule in HIPAA? Give some examples.

• Health care providers who transmit any health information electronically in connection with certain transactions.
• Health plans.

• Health care clearinghouses

6. What information is protected in HIPAA?

a. Health care claims or equivalent encounter information
b. Health care payment and remittance advice
c. Coordination of benefits
d. Health care claim status
e. Enrollment or