An Overview of HIPAA
The Health Information Portability and Accountability Act (HIPAA) was developed in order to address discriminatory practices in the provision and retention of group health insurance coverage, and to establish standards for the identification, security and sharing of medical records and other private patient information. HIPAA was passed on August 21, 1996, although the final version of the rules did not go into effect until April 14, 2001. A two year grace period was given to allow covered entities to bring their practices into compliance with these new regulations. Thus, HIPAA-compliant practices were universally adopted throughout the United States on April 14, 2003.
HIPAA contains two primary titles. Title I, Health Care Access, Portability and Renewability, prevents discrimination in enrollment and disparity in health care premiums charged to employees and their families based upon health factors or preexisting conditions. Persons employed at an entity which provides group medical coverage must be granted benefits equal to those of similarly situated individuals within the group plan, regardless of medical status or preexisting conditions. These benefits must be provided at the same costs. Furthermore, individuals with “creditable coverage” who change employers may only have benefits for preexisting conditions excluded for a maximum period of 12 months under most circumstances. Assuming there has been a break in coverage of 62 days or fewer, an individual may receive credit for time he or she had continuous coverage against the 12 month exclusion period.
Title II, Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reform, gave rise to the bulk of the rules which affect the day-to-day operations of health care providers and patients. Title II was designed to respond to the increasing use of electronic resources to acquire and transmit confidential patient data. It has two primary...