What Is the HIPAA?

Significance

By allowing former employees to continue health insurance coverage for an extended period of time under an existing plan when they left their posiitons, the act ensures that employees will not have gaps in coverage before they obtain new insurance with a new employer or become eligible for Medicare. This means that health insurance providers can not discriminate against people because of health status or pre-existing conditions when they seek a new plan. The act also gave individuals rights regarding the provision of medical information in the areas of personal access and privacy of information.

Function

Some sections of HIPAA (Title I, Subtitle B, Sec. 111) deal with guaranteeing that people can obtain and renew individual (private) health insurance after being covered by group plans. Other areas mandate controls on fraud and abuse (Title II, Subtitle A, Sections 201 through 205). The remaining titles cover Medical Savings Accounts (Title III, Subtitle A), Self-employed health insurance deductions (Title III, Subtitle B), Long Term Care (Title III, Subtitle C) and miscellaneous administrative matters.

Significance

Besides the important extension of health insurance coverage, the HIPAA Privacy Rule was the first national involvement with protecting health information. The United States Health and Human Services issued the rule in 2000 to enable enforcement of provisions of HIPAA. Two goals were important. First, the rule protects individual's private information from unauthorized disclosure. However, to make sure that health information was not so restricted as to impede vital medical research, provisions were included that created specific exceptions to the rule.

Effects

Moving beyond the protections for continuing health insurance coverage, perhaps the most noticeable effect for individuals is the requirement that medical providers obtain informed consent to the release of any medical information and an explanation of the ways private health records are protected. Every provider obtains a signature on an explanation of these matters. The second area of the Privacy Rule spells out how patients can obtain partial or complete medical records from any provider.

Considerations

Not all private health information is covered by the privacy provisions of HIPAA. What is covered includes all health information that is individually identifiable, that is, records that could be used to identify a person. What is not included is employment records or educational records that are covered by the Family Educational Rights and Privacy Act. There are specific areas where it is allowable to release information, such as to the individual or pre-approved family members, for treatment or payment of bills and where release of information is covered by other laws. The Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, was signed by President Clinton on August 21, 1996. The law became effective on June 1, 1997. There were five main aims for the act.
1.To ensure employees access to health insurance after leaving an employer;
2.To correct existing waste, fraud and abuses in the health insurance industry;
3.To promote medical savings accounts;
4.To ensure access of individuals to long-term care;
5.To simplify administration of health insurance.