What Are HIPAA Responsibilities to Patients?

The Health Insurance Portability and Accountability Act, or HIPAA, is a federal regulation governing health care records. Enacted primarily to protect patient privacy, HIPAA extends other rights to patients as well. Your primary health care provider and your health insurance company are bound by these regulations, but HIPAA extends to other situations such as hospital stays.

Privacy

• HIPAA regulations protect patient privacy by preventing doctors, hospitals and other entities who have access to your information from disclosing that information to any entity or individual that does not have such permission. Your doctor must protect your electronic and paper records. His practice faces fines if he provides inadequate protection that leaves your records and information exposed. HIPAA also requires that you receive notice and the opportunity to provide or deny permission before an entity shares your information.

Pre-Existing Conditions

• An extension of the privacy regulations in the HIPAA rules makes it more difficult for insurance carriers to deny coverage because of pre-existing conditions. Prior to HIPAA, carriers could use your health care records to deny future coverage. Now, if you have had "creditable" insurance for 12 months or longer with no lapse of that coverage for at least 63 days, an insurer cannot cite pre-existing conditions as a reason to deny new coverage.

Ease of Access

• Under the HIPAA regulations, you can ask to see or receive a copy of your health care records at any time and your health care provider has 30 days to provide your records or a reason why she cannot do so. Your provider may still assess fees for printing or mailing your records, according to your provider's procedures. Your health care provider does not need to give you all of your records, but if she does not, she must tell you why she is withholding them.

Correct Information

• HIPAA regulations give you the right to complete and accurate information in your medical file. You have the right to add information or to correct any wrong information. If your doctor or hospital does not believe that any information is wrong, you have the right to insert a notification in your medical file stating that you disagree with information. Your health care provider has 60 days to amend your file once they receive notification, but they can extend that deadline by 30 days if they can provide a reason for the delay.