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What Are the Benefits of the HIPAA Privacy Act?

Following passage of the Health Insurance Portability and Accountability Act in 1996, the U.S. Department of Health and Human Services issued the Standards for Privacy of Individually Identifiable Health Information, otherwise known as the Privacy Rule. The department's purpose in establishing the Privacy Rule was to ensure prompt, accurate transmission of health information, thereby protecting a patient's health and well being. At the same time, the Privacy Rule safeguarded the confidentiality of the patient's medical records through rules and regulations aimed at the medical community and its peripheral providers.

  1. Privacy Rule Coverage

    • HIPAA's Privacy Rule benefits health care consumers by ensuring that health plans, health care providers and health care clearinghouses comply with the restrictions specific to the Privacy Rule. Health plans encompass individual and group plans that provide coverage related to medical care including heath, vision, dental and prescription drug plans. Health maintenance organizations, Medicare, Medicaid, those who provide long-term care insurance and employer- government- or church-sponsored health care plans must also adhere to the Privacy Rule. Any health care provider that transmits data electronically must submit to the regulations tendered under the Privacy Rule. If a health care clearinghouse processes individually recognizable information between a health care provider and a health care plan, the clearinghouse must adhere to the Privacy Rule.

    Protected Information

    • HIPAA's Privacy Rule preserves an individual's private information, which is kept by or transmitted by any of the aforementioned entities or any of their business associates. It does not matter if the sensitive information is transmitted via paper, through conversation or electronically, all are covered. The Privacy Rule considers a patient's entire mental or physical health history as private, any identifiable source of the health care provided as private and the financial means by which the individual the patient's health care was settled as private.

    Uses and Disclosures

    • Basically, no patient information may escape the hands of an entity covered under the Privacy Rule unless the Privacy Rule permits the health information's release, or if the individual authorizes, in writing, any transmission. There are only two incidents: when the patient makes the request or when HHS conducts a compliance review or undertakes an enforcement action, when health information must be divulged.

    Exceptions

    • The Privacy Rule does not apply to a group health plan with less than 50 participants that is controlled by the employer that established the plan. Health information that does not reasonably identify a patient is not covered under HIPAA's Privacy Rule.

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