Health Insurance Portability and Accountability Act (HIPAA)
Health Insurance Portability and Accountability Act (HIPAA)
If you’ve been to the doctor, you were likely given a HIPAA privacy notice that explained some protections for your health information. The Health Insurance Portability and Accountability Act was passed in 1996 to regulate the disclosure of individuals’ personal health information to health plans and providers. These are spelled out under HIPAA’s Privacy Rule, which:
- Gives patients control over how their health information is used
- Defines how health plans and providers can use and disclose health records
- Permits disclosure of private health information under special circumstances
- Provides accountability and penalties for violating the privacy of your personal health information
Protections
HIPAA also provides protections in the way of portability and continuity of health insurance coverage. Its major provisions include:
- Limiting exclusions for preexisting medical conditions. A pre-existing condition is a condition for which you received medical care or advice, or a diagnosis, in the six months prior to enrolling in your current healthcare plan.
- No longer treating pregnancy as a pre-existing condition.
- No longer treating genetic information as a pre-existing condition in the absence of a diagnosis.
- Limiting exclusion for pre-existing conditions to 12 months.
- Protecting individuals from discrimination based on health-related factors.
- Prohibiting health plans and insurers from excluding individuals from coverage or charging them more for coverage due to health status.
- Prohibiting exclusions based on pre-existing conditions when an individual switches from one group health plan to another within 63 days.
- Allowing individuals to enroll for health coverage when they lose other health coverage, get married, or add new dependents.
- Expanding enrollment rights for employees who lose their coverage in certain situations
These are the major points of HIPAA.
