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HIPAA or the Health Insurance Portability and Accountability Act of 1996 is a federal law that requires the creation of a national standard to ensure sensitive health information of patients are not disclosed without prior consent of the patient.

The HIPAA Act consists of 5 titles:

-  Title 1 protects health insurance coverage for workers and their families that change or lose their jobs.

-  Title 11 prevents healthcare fraud and abuse.

-  Title 111 provides guidelines for pre-tax medical spending accounts.

-  Title 1V offers guidelines for group health plans

-  Title V governs company owned life insurance policies.

HIPAA, also known as the Public Law 104 – 191 has two main purposes; to provide health insurance coverage to people who lose their job, and to reduce administrative costs of healthcare by standardizing electronic transmission of administrative and financial transactions. The other purposes include addressing fraud, wrongful delivery of healthcare and improving long-term healthcare services.

HIPAA Privacy Rule

The HIPAA Privacy Rule officially established the first national standards in the US to protect a patient’s personal or protected healthcare information (PHI).   The rule was issued to limit the use and disclosure of PHI. According to this rule, doctors are required to inform the patient regarding all the entities to which the doctor would be sharing PHI for administrative and billing purposes.

Protected Healthcare Information or PHI includes a patient's name, address, birth date and Social Security number, an individual's physical or mental health condition, any additional care provided to an individual or information concerning the payment for the care provided to the individual that identifies the patient, or information for which there is a reasonable basis to believe could be used to identify the patient.

The penalties for breaking this rule are large. The charges start from $100 for unknowingly sharing information $1.5 million for repeat violators.

This is just a quick overview of HIPAA for you. Join our webinar on HIPAA for a more detailed understanding of the HIPAA titles and what hospitals need to be aware of with regard to a patient’s protected healthcare information.