HIPAA & Privacy
What is HIPPA?
HIPAA stands for the federal Health Insurance Portability and Accountability Act of 1996. The primary goals of the law are to make it easier for people to keep health insurance, protect the confidentiality and security of health care information, and help the health care industry control administrative costs.
HIPAA is divided into different titles or sections that address a unique aspect of health insurance reform. The two main sections are:
Title I: Health Care Portability
- Title I, which deals with portability
- Title II, which focuses on administrative simplification
This section allows individuals to carry their health insurance from one job to another so that they do not have a lapse in coverage. It also restricts health plans from requiring information about pre-existing conditions on individuals who switch from one health plan to another. The Tennessee Department of Commerce and Insurance
can assist you if you have any questions regarding the portability of your health plan if you change jobs. You may call them at (615) 741-2218, or (800) 342-4029 if calling from inside Tennessee.
Title II: Administrative Simplification
This section establishes a set of standards for receiving, transmitting, and maintaining health care information and ensuring the privacy and security of individuals' identifiable information. The HIPAA electronic data requirements are meant to encourage the health care industry to move the handling and transmission of patient information from manual to electronic systems in order to improve security, lower costs, and lower the error rate.
Privacy & Compliance
HIPAA provides for the protection of individuals' identifiable health information that is transmitted or maintained in any form or medium. The privacy rules affect the day-to-day business operations of all organizations that provide medical care and maintain personal health information. HIPPA requires the following entities to comply:
- Health care clearinghouses: This category includes businesses that process or facilitate the processing of health information received from other businesses. It includes groups such as physician and hospital billing services.
- Health care providers: This category includes any provider of medical or other health services that bills or is paid for health care in the normal course of business. Health care includes preventive, diagnostic, therapeutic, rehabilitative, maintenance, or palliative care, and counseling, services, assessment, or procedure with respect to the physical or mental condition, or functional status of an individual.
- Health plans: This category includes individuals or group plans that provide or pay the cost of medical care and includes both Medicare and Medicaid programs.