Statutes and Regulations

Statutes and Regulations


The primary statutes that introduced Administrative Simplification provisions are the:



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Learn more about the HIPAA Administrative Simplification provisions: 

HIPAA also defines privacy and security requirements for protected health information.


  • The Patient Protection and Affordable Care Act, or ACA expanded on the HIPAA provisions, including by requiring operating rules for transactions.

    In a separate provision, the ACA directs HHS to conduct outreach to advisory bodies, including the National Committee for Vital and Health Statistics (NCVHS), for input on potential improvements to Administrative Simplification such as:

    • Use of a uniform enrollment for health care providers
    • Expanding scope of standards and operating rules to apply to health-related transactions conducted by organizations like auto insurers
    • Standardized forms for financial audits required by health plans and others
    • More transparent and consistent approach to claims edits by health plans


Page Last Modified:
04/03/2024 03:37 PM