Department of Health Services Logo

 

Wisconsin Department of Health Services

HIPAA Home

Overview

HIPAA  Privacy Practices Notices and Forms

DHS Programs and HIPAA

Acronyms, Terms and Definitions

Resources

Search HIPAA

Department of Health Services Programs and HIPAA

For the Administrative Simplification aspects of HIPAA, health plans are generally defined as any individual or group plan that provides or pays for health care. Certain publicly funded programs are specifically listed by the federal Department of Health and Human Services in the federal regulations it has issued. Several of these kinds of health plans equate to federal and state human service programs supervised by the Wisconsin Department of Health and Family Services.

Here you will find the Wisconsin programs that DHS believes are impacted by the Administrative Simplification aspects of HIPAA.

Follow the links below to be directed to a particular State of Wisconsin Department of Health and Family Services division or program we believe is impacted by the Administrative Simplification aspects of HIPAA.

Program Name

HIPAA Impact

DHS Division

Medicaid, WisconCare, SeniorCare, BadgerCare Plus, HIRSP and  Wisconsin Chronic Disease Programs

Covered entities as health plans. 

Division of Health Care Access and Accountability

HIPAA and WI Medicaid

General Relief Medical A covered entity as a health plan. Division of Health Care Access and Accountability
DHS Facilities A covered entity as a provider.

Division of Long Term Care

CIP, COP-W, Community Integration Program, Brain Injury Waiver Medicaid home and community based waiver programs are part of Medicaid and therefore a health plan. County waiver agencies that administer them are business associates of DHS and must comply with HIPAA as health plans.

Division of Long Term Care

Community Options Program (COP) COP meets the exclusions for governmental programs from health plan status. Counties may chose to treat it as a heath plan or not, considering how reasonable it is to separate it's administration from those of the Home and Community Based Waiver programs.  Division of Long Term Care
Family Care Care Management Organizations (CMO's) are covered entities as heath plans. Resources centers do not appear to be covered entities. 

Division of Long Term Care

Partnership/PACE A covered entity as a health plan. The four local sites will need to comply with HIPAA.

Division of Long Term Care

Wisconsin Well Woman Program A covered entity as a health plan. Division of Public Health

View a document listing state wide programs supervised by DHS we believe are NOT health plans under HIPAA (PDF, 265 KB)

Last updated:  July 28, 2014