HIPAA establishes medical privacy protections to prevent misuse of patient health care data.
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law enacted in 1996 that protects employees from losing health coverage when they change jobs. The law prohibits health care plans from discriminating against enrollees based upon their medical condition and other health factors. HIPAA also put in place a federal standard for protecting the privacy of patient medical records along with guidelines for securing the data, as more health information is stored and transmitted electronically. The law also establishes a set of rights with respect to use and disclosure of the medical information a health care organization maintains on a patient.
Limits Preexisting Condition Exclusions
HIPAA makes it easier for individuals with prior medical concerns to get coverage for those conditions when they change jobs. Before the law took effect, employer-sponsored group health plans could deny a new enrollee coverage for medical conditions the employee or his dependents had prior to enrolling in the plan. HIPAA allows health plans to deny coverage for a preexisting condition on a new enrollee only if he received medical advice, diagnosis, care or treatment for the condition during the six months before enrolling, according to the U.S. Department of Labor. HIPAA limits the length of time a plan can exclude coverage to one year.
Bans Coverage Discrimination
HIPAA also prohibits health plans from denying health coverage to employees and their dependent family members based on any health factors they may have, including prior medical conditions, previous claims experience and genetic information, DOL says. The law also bans health care plans from charging an enrollee more than "similarly situated" individuals based on health status, medical condition, prior health history, genetic information or disability.
Safeguards Medical Records
HIPAA established federal standards designed to protect the privacy of patient medical records. The law requires hospitals, health plans and medical claim processors to safeguard the health information doctors, nurses and other health care providers put in your medical record--including your billing information--from inappropriate use and disclosure, the U.S. Department of Health and Human Services says. The law requires health care providers to limit disclosure of patient health records to the minimum information necessary for the intended purpose. Health care professionals also must establish contracts with their business partners to extend the privacy protection after it leaves the hospital, HHS says.
Establishes Right to Inspect Records
HIPAA also gives patients the right to monitor and to some extent control use and disclosure of their health care data. Under the law, patients have the right to ask to review, copy and amend their health records, HHS says. Patients are entitled to receive notice from a hospital or other health organization that describes how their medical records might be used and shared. The law also gives patients the right to decide who has permission to use their records and for what purposes. HIPAA also requires health care organizations to honor patient requests to receive a report on when and why health information was shared, HHS says.
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