Complaint(s) Enforcement Statistical Reports

The Centers for Medicare & Medicaid Services (CMS) Division of National Standards, on behalf of the Department of Health and Human Services (HHS), announces the release of revised statistical reports regarding the CMS HIPAA complaint enforcement program. The Complaint Enforcement Program supports implementation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) adopted Administration Simplification standards for transactions, code sets, unique identifiers and operating rules.

The revised statistical report(s) will illustrate to external stakeholders the quantity and quality of complaints received by CMS. In addition, the revised statistical report(s) will provide complaint types submitted by covered entities, violations based on type of transaction, and resolution time frames. Based on industry feedback, we believe the revised reports will provide greater insight and foster greater collaboration with covered entities to achieve full compliance with HIPAA Administrative Simplification.  

We welcome feedback/comments on the information provided and look forward to our collaborative efforts to inform the industry on the CMS reactive complaint process and outcomes. To share questions or comments, contact AdministrativeSimplification@cms.hhs.gov.