Does a Foreign Insurer Have to Be HIPAA Compliant?

HIPAA is notable for two reasons: the privacy rule which grants consumers legal rights over their private medical information and the right to port one's prior health coverage to a new plan and get credit for the period of coverage for any pre-existing conditions.

Significance

• Globalization raises questions about the Health Insurance Portability and Accountability Act mandates. Foreign insurers are interested in providing coverage for American employees. Additionally, U.S. companies with overseas operations may engage a foreign insurer for coverage on overseas soils. Self-insured international companies engage in business in the U.S. Each of these situations trigger HIPAA compliance issues.

Function

• HIPAA expressly outlines the categories of those governed: health plans, health providers and health clearinghouses. Health plans include insurance companies, HMOs and self-insured health plans. Health care providers include doctors, nurses, nursing homes, pharmacies, dentists and other medical providers. Health care clearinghouses represent companies that electronically process health information received from another entity.

Considerations

• The rules and regulations implementing HIPAA do not make distinctions between national insurers and foreign insurers. As of 2010, the Center for Medicare and Medicaid Services is the only federal agency that has announced that overseas insurers that make Medicare or Medicaid payments to U.S. citizens must adhere to HIPAA mandates.