PrintThe Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a reform designed primarily to help protect health insurance coverage for workers and their families when they switch jobs. The plan, which took effect in April of 2003, must be followed by doctors, hospitals and other health care providers.
There are eligibility requirements that must be met before HIPAA can help you. First, you need to have had 18 months of coverage without a break of more than 63 days and your most recent coverage must have been through a group health plan. You cannot be eligible for Medicare or Medicaid or have other health insurance. In addition, you need to have used up your COBRA coverage or any similar ongoing coverage.
If you are eligible and act within 63 days of losing coverage, HIPAA guarantees that you can purchase some type of coverage and will have a choice of at least two options. It essentially provides protection for anyone left out of health coverage after losing his or her job and once COBRA runs out. It cannot set limits on what health care companies charge, which may be done under state laws, but it can keep individuals covered during a time of transition from one job to another. HIPAA also, depending on the health plan and the circumstances, prohibits a plan from denying coverage or charging more based on your health history or a pre-existing condition.
The other important aspect of HIPAA, which affects everyone, focuses on the growing privacy concerns of patients and doctors. New standards are now in place, through the Department of Health and Human Services, that address the secrecy and privacy of patient information and all health data. National standards have been established to ensure all electronic health data transmissions are handled in a specific manner to protect personal information from being lost, stolen or received by parties who have not been authorized to have such personal information. In short, doctors, hospitals and health care providers must be more diligent about protecting all health records, particularly when electronically stored or transferred. Standard procedures are now set up to protect confidentiality and availability of information.
As a patient, you now have the right to get a copy of your medical records (although a handling fee may be charged) and the right to have any inaccurate data corrected or an addendum added. The distribution of medical data is also closely monitored. You have the right to know where any personal information has been distributed or shared for non-medical reasons and can establish guidelines regarding any such sharing of personal data. You can also determine how you want material communicated to you.
In time, as new technologies and the means of communications increase, HIPAA will undoubtedly have to be amended to address the privacy policies, but for now, this is an important step in protecting patients’ rights in the new electronic age.
