The Department of Health and Human Services’ (HHS) Centers for Medicare and Medicaid Services (CMS) is set to launch a review program in April 2019, to ascertain whether HIPAA covered entities are in compliance with Administrative Simplification rules for electronic health care transactions. A mix of health plans and clearinghouses will be included in the review with the goal of encouraging a more proactive stance on maintaining HIPAA compliance.

Of these included entities, CMS intends to randomly select multiple health care organizations, including some that deal with Medicaid and Medicare, to conduct the compliance review. While this review will be conducted on randomly selected participants, a set of volunteers was utilized in the program’s pilot in 2018 as a way to streamline the review process.

These reviews were designed with the intent to support current and future Administrative Simplification transaction standards which helps to ease the administrative burden on the health care industry as a whole. If the entities chosen for review are found to be out of compliance, the CMS review program will offer corrective action plans to help them become compliant. If they still fail to enact the prescribed action plans, additional corrective action may be taken that could include civil and monetary penalties. Consider using the HIPAAgps platform to help equip your health care organization for administrative compliance with the HIPAA standards.

The progressive penalty process is meant to give sufficient incentive for establishments to clean up any out-of-compliance practices they may have before more severe consequences begin to accrue. As a last resort, if an organization continues to refuse to take the necessary actions to become compliant, civil and monetary penalties could possibly be leveraged.

Once this Compliance Review Program is completed, CMS intends to continue with ongoing random compliance reviews as a way to bolster HIPAA Administrative Simplification adherence and maintain it.

Taking a more proactive approach to HIPAA compliance standards is a fantastic way to keep your organization running at peak efficiency while also avoiding financial penalties. Plus, if you act now, you could potentially avoid the headache of being supervised while attempting to create and implement a new set of guidelines and practices. provides online training, assessments, and documentation to help make compliance simple and easy. Try our 7 Day, Risk-Free trial to see for yourself.