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Digital Standards and Operating Rules adopted by HHS under HIPAA

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) required HHS to establish digital standards for business-related tasks like submitting claims and getting paid. The goal is to reduce paperwork and streamline business processes across the health care system.

Standards allow information to be shared digitally in consistent ways. With common standards for content and formats, information moves quickly as it is shared between providers and health plans in predictable ways.

All health plans, other payers, and providers who exchange business and insurance-related tasks digitally must comply with these Administrative Simplification standards adopted by HHS under HIPAA.

Visit the newly enhanced Administrative Simplification adopted standards and operating rules page to learn about:

  • Digital standards for business tasks
  • Business, or operating, rules
  • Standard code sets