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2026 CBCS EXAM PREP
2026 HIPAA TITLES I-V & HIPAA 5 RULES
| Term | Definition |
|---|---|
| HIPAA TITLES I-V | Health Insurance Portability and Accountability Act of 1996 — contains five titles, each covering a different area of healthcare regulation, tax policy, or revenue law grouped into 2 main categories: Administrative Simplification and Privacy (primarily Title II) and Insurance Reform and Tax-Related Provisions (Titles I, III, IV, and V) |
| TITLE I | Health Care Access, Portability, and Renewability; Protects health insurance coverage for workers and their families when they change or lose their jobs |
| TITLE II | Administrative Simplification; Establishes standards for the electronic exchange of health information and protects the privacy and security of health data |
| TITLE III | Tax-Related Health Provisions; Provides for the tax treatment of health care costs and benefits |
| TITLE IV | Application and Enforcement of Group Health Plan Requirements; Addresses the requirements for group health plans and their enforcement |
| TITLE V | Revenue Offsets; Relates to the treatment of certain health insurance policies and the tax implications of those policies |
| HIPAA 5 MAIN RULES *PRIMARILY UNDER TITLE II | The core regulatory rules that apply to covered entities and business associates, primarily under Title II and some related titles |
| PRIVACY RULE | Sets federal standards for protecting protected health information (PHI), including patient rights to access, amend, & restrict use/disclosure of PHI |
| SECURITY RULE | Requires administrative, physical, and technical safeguards to protect electronic PHI (ePHI) |
| ELECTRONIC TRANSACTIONS AND CODE SETS RULE | Standardizes electronic healthcare transactions (e.g., claims, eligibility) and identifiers like the NPI |
| UNIQUE IDENTIFIERS RULE | Mandates the use of standardized identifiers for healthcare providers, health plans, and clearinghouses |
| RIGHT OF ACCESS RULE | Grants patients the right to inspect and obtain copies of their PHI, and to request corrections |
| HIPAA: TITLES vs. RULES | Titles = Legislative sections of the law, each with multiple rules and provisions. Main Rules = Specific, enforceable standards (often just one per title) that set operational requirements for compliance |
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