Under Title II of The Health Insurance Portability and Accountability Act, the administrative simplification provision:

Question

Options

• AForbids individual health plans from denying coverage or imposing preexisting condition exclusions
• BCreates opportunities for fraud and abuse within the health care system
• CRequires the establishment of national standards for electronic health care transactions
• DProtects health insurance coverage for workers and their families

• A
  6% (1)
• C
  88% (15)
• D
  6% (1)

Explanation

Title II of HIPAA's Administrative Simplification provision specifically targets the operational and technical side of healthcare - it mandates national standards for electronic health care transactions (such as claims, eligibility checks, and remittances), along with unique identifiers and security/privacy standards for health information, making C correct.

Why the distractors are wrong:

• A describes Title I of HIPAA, which addresses portability and protection against preexisting condition exclusions - a separate title entirely.
• B is the opposite of HIPAA's intent; the law includes anti-fraud provisions (also under Title II) specifically to combat fraud and abuse, not enable it.
• D also describes Title I, which protects coverage continuity for workers changing or losing jobs.

Memory tip: Think "Administrative Simplification = Standardization." The word simplification is your clue - it's about simplifying healthcare administration through uniform electronic standards, not about who gets coverage (that's Title I's job).

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