HIPAA Policies & Procedures

When Congress passed the Health Insurance Portability and Accountability Act of 1966 (HIPAA), it created a health-care coat of many colors, containing seemingly disparate elements that impact your ability to enroll in health-care plans, the security of your personal health records and the security of digitized personal medical information. At the same time, the act works toward improving the quality of your health care by mandating moving all patient health records to an easily shared and quickly transmitted digital format.

Guaranteed insurability

• HIPAA guarantees your insurability (including coverage of preexisting conditions) when you leave one employer's group health-care plan for another employer's plan, or purchase an individual plan on your own.

  The term \"portability\" is something of a misnomer as you don't actually carry your insurance with you, but rather qualify for your new policy without the insurer having to underwrite your policy. As long as your previous health-care policy covered your preexisting condition, your new policy will cover it as well (though the insurer can impose a waiting period of up to 12 months).

Credible coverage

• You can avoid some or all of the waiting period if you had \"creditable coverage\" that covered (insured) a condition your new plan would call preexisting, and you have not had a \"significant break\" in your coverage. HIPAA lets you reduce the exclusion period mentioned above by the time you were previously covered.

  HIPAA defines creditable coverage to include almost all comprehensive group and individual health plans, and a significant break as any period of time you go more than 63 days without creditable coverage.

Privacy

• HIPAA required that the Health and Human Services Department create standards for the security of health records (both paper and digital), which they did in 2000 (and modified in 2002). Called the Privacy Rule, it set the first national standards to protect all identifiable health records. Identifiable records have your name on them (a prescription label, for example) or contain information that would let someone identify you. Health-care providers (including pharmacies), health plans (insurance) and health-care clearing houses must comply with the Privacy Rule.

  Prior to HIPAA, potential employers, life insurance agencies and lending institutions could, and did, access your health records before approving any requests you made of them.

Security standard

• HIPAA also required that the Department of Health and Human Services create standards for the security of digital (electronic) health-care information. These standards define the security procedures that companies and caregivers inputting and handling data must use to protect it.

Impact

• If you've wondered why your doctor's nurse asks you to sign his office's privacy policy once a year, the answer is HIPAA. HIPAA had?and continues to have?a major impact on the availability of health care, as well as on the security of your private health information. Now you control who has access to your private data; and now you can leave (or lose) your employer's group health insurance knowing you can get coverage, even with a preexisting condition.