Introduction to HIPAA

"Top 10" HIPAA FAQs:

1. What does the HIPAA Privacy Rule do?
2. What is the difference between “consent” and “authorization” under the HIPAA Privacy Rule?
3. Generally, what does the HIPAA Privacy Rule require the average provider or health plan to do?
4. Who must comply with HIPAA privacy standards?
5. When does the Privacy Rule allow covered entities to disclose protected health information to law enforcement officials?
6. Does the HIPAA Privacy Rule allow parents the right to see their children’s medical records?
7. If patients request copies of their medical records as permitted by the Privacy Rule, are they required to pay for the copies?
8. May a covered entity use or disclose a patient’s entire medical record based on the patient’s signed Authorization?
9. Why is the HIPAA Privacy Rule needed?
10. Does the HIPAA Privacy Rule permit a doctor to discuss a patient’s health status, treatment, or payment arrangements with the patient’s family and friends?

HIPAA Overview

The Health Insurance Portability and Accountability Act of 1996, known as HIPAA (not HIPPA), includes important protections for millions of working Americans and their families. HIPAA is a federal law, but many states have their own variations of the law, which may impose other (stricter) requirements. Please see the State HIPAA links, below, for additional information for your state.

HIPAA amends the Internal Revenue Code to improve portability and continuity of health insurance coverage in the group and individual markets, to combat waste, fraud and abuse in health insurance and health care delivery, to promote the use of medical savings accounts, to improve access to long-term care services and coverage, to simplify the administration of health insurance, administrative simplification, and for other purposes. HIPAA may:

1. Increase your ability to get health coverage for yourself and your dependents if you start a new job;
2. Lower your chance of losing existing health care coverage, whether you have that coverage through a job, or through individual health insurance;
3. Help you maintain continuous health coverage for yourself and your dependents when you change jobs; and
4. Help you buy health insurance coverage on your own if you lose coverage under an employer's group health plan and have no other health coverage available.

Among its specific protections, HIPAA: 

1. Limits the use of pre-existing condition exclusions;
2. Prohibits group health plans from discriminating by denying you coverage or charging you extra for coverage based on your or your family member's past or present poor health;
3. Guarantees certain small employers, and certain individuals who lose job-related coverage, the right to purchase health insurance; and
4. Guarantees, in most cases, that employers or individuals who purchase health insurance can renew the coverage regardless of any health conditions of individuals covered under the insurance policy.