Title 45

Volume 2 CHAPTER A SUBCHAP C

Subchapter C - Administrative Data Standards And Related Requirements

45:2.0.1.2.18	PART 160	PART 160 - GENERAL ADMINISTRATIVE REQUIREMENTS
45:2.0.1.2.18.1	SUBPART A	Subpart A - General Provisions
45:2.0.1.2.18.1.1.1	SECTION 160.101	160.101 Statutory basis and purpose.
45:2.0.1.2.18.1.1.2	SECTION 160.102	160.102 Applicability.
45:2.0.1.2.18.1.1.3	SECTION 160.103	160.103 Definitions.
45:2.0.1.2.18.1.1.4	SECTION 160.104	160.104 Modifications.
45:2.0.1.2.18.1.1.5	SECTION 160.105	160.105 Compliance dates for implementation of new or modified standards and implementation specifications.
45:2.0.1.2.18.2	SUBPART B	Subpart B - Preemption of State Law
45:2.0.1.2.18.2.1.1	SECTION 160.201	160.201 Statutory basis.
45:2.0.1.2.18.2.1.2	SECTION 160.202	160.202 Definitions.
45:2.0.1.2.18.2.1.3	SECTION 160.203	160.203 General rule and exceptions.
45:2.0.1.2.18.2.1.4	SECTION 160.204	160.204 Process for requesting exception determinations.
45:2.0.1.2.18.2.1.5	SECTION 160.205	160.205 Duration of effectiveness of exception determinations.
45:2.0.1.2.18.3	SUBPART C	Subpart C - Compliance and Investigations
45:2.0.1.2.18.3.1.1	SECTION 160.300	160.300 Applicability.
45:2.0.1.2.18.3.1.2	SECTION 160.302	160.302 [Reserved]
45:2.0.1.2.18.3.1.3	SECTION 160.304	160.304 Principles for achieving compliance.
45:2.0.1.2.18.3.1.4	SECTION 160.306	160.306 Complaints to the Secretary.
45:2.0.1.2.18.3.1.5	SECTION 160.308	160.308 Compliance reviews.
45:2.0.1.2.18.3.1.6	SECTION 160.310	160.310 Responsibilities of covered entities and business associates.
45:2.0.1.2.18.3.1.7	SECTION 160.312	160.312 Secretarial action regarding complaints and compliance reviews.
45:2.0.1.2.18.3.1.8	SECTION 160.314	160.314 Investigational subpoenas and inquiries.
45:2.0.1.2.18.3.1.9	SECTION 160.316	160.316 Refraining from intimidation or retaliation.
45:2.0.1.2.18.4	SUBPART D	Subpart D - Imposition of Civil Money Penalties
45:2.0.1.2.18.4.1.1	SECTION 160.400	160.400 Applicability.
45:2.0.1.2.18.4.1.2	SECTION 160.401	160.401 Definitions.
45:2.0.1.2.18.4.1.3	SECTION 160.402	160.402 Basis for a civil money penalty.
45:2.0.1.2.18.4.1.4	SECTION 160.404	160.404 Amount of a civil money penalty.
45:2.0.1.2.18.4.1.5	SECTION 160.406	160.406 Violations of an identical requirement or prohibition.
45:2.0.1.2.18.4.1.6	SECTION 160.408	160.408 Factors considered in determining the amount of a civil money penalty.
45:2.0.1.2.18.4.1.7	SECTION 160.410	160.410 Affirmative defenses.
45:2.0.1.2.18.4.1.8	SECTION 160.412	160.412 Waiver.
45:2.0.1.2.18.4.1.9	SECTION 160.414	160.414 Limitations.
45:2.0.1.2.18.4.1.10	SECTION 160.416	160.416 Authority to settle.
45:2.0.1.2.18.4.1.11	SECTION 160.418	160.418 Penalty not exclusive.
45:2.0.1.2.18.4.1.12	SECTION 160.420	160.420 Notice of proposed determination.
45:2.0.1.2.18.4.1.13	SECTION 160.422	160.422 Failure to request a hearing.
45:2.0.1.2.18.4.1.14	SECTION 160.424	160.424 Collection of penalty.
45:2.0.1.2.18.4.1.15	SECTION 160.426	160.426 Notification of the public and other agencies.
45:2.0.1.2.18.5	SUBPART E	Subpart E - Procedures for Hearings
45:2.0.1.2.18.5.1.1	SECTION 160.500	160.500 Applicability.
45:2.0.1.2.18.5.1.2	SECTION 160.502	160.502 Definitions.
45:2.0.1.2.18.5.1.3	SECTION 160.504	160.504 Hearing before an ALJ.
45:2.0.1.2.18.5.1.4	SECTION 160.506	160.506 Rights of the parties.
45:2.0.1.2.18.5.1.5	SECTION 160.508	160.508 Authority of the ALJ.
45:2.0.1.2.18.5.1.6	SECTION 160.510	160.510 Ex parte contacts.
45:2.0.1.2.18.5.1.7	SECTION 160.512	160.512 Prehearing conferences.
45:2.0.1.2.18.5.1.8	SECTION 160.514	160.514 Authority to settle.
45:2.0.1.2.18.5.1.9	SECTION 160.516	160.516 Discovery.
45:2.0.1.2.18.5.1.10	SECTION 160.518	160.518 Exchange of witness lists, witness statements, and exhibits.
45:2.0.1.2.18.5.1.11	SECTION 160.520	160.520 Subpoenas for attendance at hearing.
45:2.0.1.2.18.5.1.12	SECTION 160.522	160.522 Fees.
45:2.0.1.2.18.5.1.13	SECTION 160.524	160.524 Form, filing, and service of papers.
45:2.0.1.2.18.5.1.14	SECTION 160.526	160.526 Computation of time.
45:2.0.1.2.18.5.1.15	SECTION 160.528	160.528 Motions.
45:2.0.1.2.18.5.1.16	SECTION 160.530	160.530 Sanctions.
45:2.0.1.2.18.5.1.17	SECTION 160.532	160.532 Collateral estoppel.
45:2.0.1.2.18.5.1.18	SECTION 160.534	160.534 The hearing.
45:2.0.1.2.18.5.1.19	SECTION 160.536	160.536 Statistical sampling.
45:2.0.1.2.18.5.1.20	SECTION 160.538	160.538 Witnesses.
45:2.0.1.2.18.5.1.21	SECTION 160.540	160.540 Evidence.
45:2.0.1.2.18.5.1.22	SECTION 160.542	160.542 The record.
45:2.0.1.2.18.5.1.23	SECTION 160.544	160.544 Post hearing briefs.
45:2.0.1.2.18.5.1.24	SECTION 160.546	160.546 ALJ's decision.
45:2.0.1.2.18.5.1.25	SECTION 160.548	160.548 Appeal of the ALJ's decision.
45:2.0.1.2.18.5.1.26	SECTION 160.550	160.550 Stay of the Secretary's decision.
45:2.0.1.2.18.5.1.27	SECTION 160.552	160.552 Harmless error.
45:2.0.1.2.19	PART 162	PART 162 - ADMINISTRATIVE REQUIREMENTS
45:2.0.1.2.19.1	SUBPART A	Subpart A - General Provisions
45:2.0.1.2.19.1.1.1	SECTION 162.100	162.100 Applicability.
45:2.0.1.2.19.1.1.2	SECTION 162.103	162.103 Definitions.
45:2.0.1.2.19.2	SUBPART B	Subparts B-C [Reserved]
45:2.0.1.2.19.3	SUBPART D	Subpart D - Standard Unique Health Identifier for Health Care Providers
45:2.0.1.2.19.3.1.1	SECTION 162.402	162.402 [Reserved]
45:2.0.1.2.19.3.1.2	SECTION 162.404	162.404 Compliance dates of the implementation of the standard unique health identifier for health care providers.
45:2.0.1.2.19.3.1.3	SECTION 162.406	162.406 Standard unique health identifier for health care providers.
45:2.0.1.2.19.3.1.4	SECTION 162.408	162.408 National Provider System.
45:2.0.1.2.19.3.1.5	SECTION 162.410	162.410 Implementation specifications: Health care providers.
45:2.0.1.2.19.3.1.6	SECTION 162.412	162.412 Implementation specifications: Health plans.
45:2.0.1.2.19.3.1.7	SECTION 162.414	162.414 Implementation specifications: Health care clearinghouses.
45:2.0.1.2.19.4	SUBPART E	Subpart E [Reserved]
45:2.0.1.2.19.5	SUBPART F	Subpart F - Standard Unique Employer Identifier
45:2.0.1.2.19.5.1.1	SECTION 162.600	162.600 Compliance dates of the implementation of the standard unique employer identifier.
45:2.0.1.2.19.5.1.2	SECTION 162.605	162.605 Standard unique employer identifier.
45:2.0.1.2.19.5.1.3	SECTION 162.610	162.610 Implementation specifications for covered entities.
45:2.0.1.2.19.6	SUBPART G	Subparts G-H [Reserved]
45:2.0.1.2.19.7	SUBPART I	Subpart I - General Provisions for Transactions
45:2.0.1.2.19.7.1.1	SECTION 162.900	162.900 [Reserved]
45:2.0.1.2.19.7.1.2	SECTION 162.910	162.910 Maintenance of standards and adoption of modifications and new standards.
45:2.0.1.2.19.7.1.3	SECTION 162.915	162.915 Trading partner agreements.
45:2.0.1.2.19.7.1.4	SECTION 162.920	162.920 Availability of implementation specifications and operating rules.
45:2.0.1.2.19.7.1.5	SECTION 162.923	162.923 Requirements for covered entities.
45:2.0.1.2.19.7.1.6	SECTION 162.925	162.925 Additional requirements for health plans.
45:2.0.1.2.19.7.1.7	SECTION 162.930	162.930 Additional rules for health care clearinghouses.
45:2.0.1.2.19.7.1.8	SECTION 162.940	162.940 Exceptions from standards to permit testing of proposed modifications.
45:2.0.1.2.19.8	SUBPART J	Subpart J - Code Sets
45:2.0.1.2.19.8.1.1	SECTION 162.1000	162.1000 General requirements.
45:2.0.1.2.19.8.1.2	SECTION 162.1002	162.1002 Medical data code sets.
45:2.0.1.2.19.8.1.3	SECTION 162.1011	162.1011 Valid code sets.
45:2.0.1.2.19.9	SUBPART K	Subpart K - Health Care Claims or Equivalent Encounter Information
45:2.0.1.2.19.9.1.1	SECTION 162.1101	162.1101 Health care claims or equivalent encounter information transaction.
45:2.0.1.2.19.9.1.2	SECTION 162.1102	162.1102 Standards for health care claims or equivalent encounter information transaction.
45:2.0.1.2.19.10	SUBPART L	Subpart L - Eligibility for a Health Plan
45:2.0.1.2.19.10.1.1	SECTION 162.1201	162.1201 Eligibility for a health plan transaction.
45:2.0.1.2.19.10.1.2	SECTION 162.1202	162.1202 Standards for eligibility for a health plan transaction.
45:2.0.1.2.19.10.1.3	SECTION 162.1203	162.1203 Operating rules for eligibility for a health plan transaction.
45:2.0.1.2.19.11	SUBPART M	Subpart M - Referral Certification and Authorization
45:2.0.1.2.19.11.1.1	SECTION 162.1301	162.1301 Referral certification and authorization transaction.
45:2.0.1.2.19.11.1.2	SECTION 162.1302	162.1302 Standards for referral certification and authorization transaction.
45:2.0.1.2.19.12	SUBPART N	Subpart N - Health Care Claim Status
45:2.0.1.2.19.12.1.1	SECTION 162.1401	162.1401 Health care claim status transaction.
45:2.0.1.2.19.12.1.2	SECTION 162.1402	162.1402 Standards for health care claim status transaction.
45:2.0.1.2.19.12.1.3	SECTION 162.1403	162.1403 Operating rules for health care claim status transaction.
45:2.0.1.2.19.13	SUBPART O	Subpart O - Enrollment and Disenrollment in a Health Plan
45:2.0.1.2.19.13.1.1	SECTION 162.1501	162.1501 Enrollment and disenrollment in a health plan transaction.
45:2.0.1.2.19.13.1.2	SECTION 162.1502	162.1502 Standards for enrollment and disenrollment in a health plan transaction.
45:2.0.1.2.19.14	SUBPART P	Subpart P - Health Care Electronic Funds Transfers (EFT) and Remittance Advice
45:2.0.1.2.19.14.1.1	SECTION 162.1601	162.1601 Health care electronic funds transfers (EFT) and remittance advice transaction.
45:2.0.1.2.19.14.1.2	SECTION 162.1602	162.1602 Standards for health care electronic funds transfers (EFT) and remittance advice transaction.
45:2.0.1.2.19.14.1.3	SECTION 162.1603	162.1603 Operating rules for health care electronic funds transfers (EFT) and remittance advice transaction.
45:2.0.1.2.19.15	SUBPART Q	Subpart Q - Health Plan Premium Payments
45:2.0.1.2.19.15.1.1	SECTION 162.1701	162.1701 Health plan premium payments transaction.
45:2.0.1.2.19.15.1.2	SECTION 162.1702	162.1702 Standards for health plan premium payments transaction.
45:2.0.1.2.19.16	SUBPART R	Subpart R - Coordination of Benefits
45:2.0.1.2.19.16.1.1	SECTION 162.1801	162.1801 Coordination of benefits transaction.
45:2.0.1.2.19.16.1.2	SECTION 162.1802	162.1802 Standards for coordination of benefits information transaction.
45:2.0.1.2.19.17	SUBPART S	Subpart S - Medicaid Pharmacy Subrogation
45:2.0.1.2.19.17.1.1	SECTION 162.1901	162.1901 Medicaid pharmacy subrogation transaction.
45:2.0.1.2.19.17.1.2	SECTION 162.1902	162.1902 Standard for Medicaid pharmacy subrogation transaction.
45:2.0.1.2.20	PART 163	PART 163 [RESERVED]
45:2.0.1.2.21	PART 164	PART 164 - SECURITY AND PRIVACY
45:2.0.1.2.21.1	SUBPART A	Subpart A - General Provisions
45:2.0.1.2.21.1.1.1	SECTION 164.102	164.102 Statutory basis.
45:2.0.1.2.21.1.1.2	SECTION 164.103	164.103 Definitions.
45:2.0.1.2.21.1.1.3	SECTION 164.104	164.104 Applicability.
45:2.0.1.2.21.1.1.4	SECTION 164.105	164.105 Organizational requirements.
45:2.0.1.2.21.1.1.5	SECTION 164.106	164.106 Relationship to other parts.
45:2.0.1.2.21.2	SUBPART B	Subpart B [Reserved]
45:2.0.1.2.21.3	SUBPART C	Subpart C - Security Standards for the Protection of Electronic Protected Health Information
45:2.0.1.2.21.3.1.1	SECTION 164.302	164.302 Applicability.
45:2.0.1.2.21.3.1.2	SECTION 164.304	164.304 Definitions.
45:2.0.1.2.21.3.1.3	SECTION 164.306	164.306 Security standards: General rules.
45:2.0.1.2.21.3.1.4	SECTION 164.308	164.308 Administrative safeguards.
45:2.0.1.2.21.3.1.5	SECTION 164.310	164.310 Physical safeguards.
45:2.0.1.2.21.3.1.6	SECTION 164.312	164.312 Technical safeguards.
45:2.0.1.2.21.3.1.7	SECTION 164.314	164.314 Organizational requirements.
45:2.0.1.2.21.3.1.8	SECTION 164.316	164.316 Policies and procedures and documentation requirements.
45:2.0.1.2.21.3.1.9	SECTION 164.318	164.318 Compliance dates for the initial implementation of the security standards.
45:2.0.1.2.21.3.1.10.1	APPENDIX Appendix A	Appendix A to Subpart C of Part 164 - Security Standards: Matrix
45:2.0.1.2.21.4	SUBPART D	Subpart D - Notification in the Case of Breach of Unsecured Protected Health Information
45:2.0.1.2.21.4.1.1	SECTION 164.400	164.400 Applicability.
45:2.0.1.2.21.4.1.2	SECTION 164.402	164.402 Definitions.
45:2.0.1.2.21.4.1.3	SECTION 164.404	164.404 Notification to individuals.
45:2.0.1.2.21.4.1.4	SECTION 164.406	164.406 Notification to the media.
45:2.0.1.2.21.4.1.5	SECTION 164.408	164.408 Notification to the Secretary.
45:2.0.1.2.21.4.1.6	SECTION 164.410	164.410 Notification by a business associate.
45:2.0.1.2.21.4.1.7	SECTION 164.412	164.412 Law enforcement delay.
45:2.0.1.2.21.4.1.8	SECTION 164.414	164.414 Administrative requirements and burden of proof.
45:2.0.1.2.21.5	SUBPART E	Subpart E - Privacy of Individually Identifiable Health Information
45:2.0.1.2.21.5.1.1	SECTION 164.500	164.500 Applicability.
45:2.0.1.2.21.5.1.2	SECTION 164.501	164.501 Definitions.
45:2.0.1.2.21.5.1.3	SECTION 164.502	164.502 Uses and disclosures of protected health information: General rules.
45:2.0.1.2.21.5.1.4	SECTION 164.504	164.504 Uses and disclosures: Organizational requirements.
45:2.0.1.2.21.5.1.5	SECTION 164.506	164.506 Uses and disclosures to carry out treatment, payment, or health care operations.
45:2.0.1.2.21.5.1.6	SECTION 164.508	164.508 Uses and disclosures for which an authorization is required.
45:2.0.1.2.21.5.1.7	SECTION 164.510	164.510 Uses and disclosures requiring an opportunity for the individual to agree or to object.
45:2.0.1.2.21.5.1.8	SECTION 164.512	164.512 Uses and disclosures for which an authorization or opportunity to agree or object is not required.
45:2.0.1.2.21.5.1.9	SECTION 164.514	164.514 Other requirements relating to uses and disclosures of protected health information.
45:2.0.1.2.21.5.1.10	SECTION 164.520	164.520 Notice of privacy practices for protected health information.
45:2.0.1.2.21.5.1.11	SECTION 164.522	164.522 Rights to request privacy protection for protected health information.
45:2.0.1.2.21.5.1.12	SECTION 164.524	164.524 Access of individuals to protected health information.
45:2.0.1.2.21.5.1.13	SECTION 164.526	164.526 Amendment of protected health information.
45:2.0.1.2.21.5.1.14	SECTION 164.528	164.528 Accounting of disclosures of protected health information.
45:2.0.1.2.21.5.1.15	SECTION 164.530	164.530 Administrative requirements.
45:2.0.1.2.21.5.1.16	SECTION 164.532	164.532 Transition provisions.
45:2.0.1.2.21.5.1.17	SECTION 164.534	164.534 Compliance dates for initial implementation of the privacy standards.
45:2.0.1.2.22	PART 165-169	PARTS 165-169 [RESERVED]

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