Health Insurance Port Ability & Accountability Act

The Health Insurance Portability and Accountability Act (HIPPA) is a law that has two main effects. HIPPA primarily prohibits an employer's health plans from excluding people who have pre-existing conditions and their families in many circumstances. The law also makes some changes to how heath care providers share and handle information related to health care.

Pre-existing Conditions

• HIPPA defines how health plans treat people with pre-existing health conditions. A health plan may deny coverage for pre-existing conditions for up to 18 months. A pre-existing condition is a condition that you have received treatment for in the last six months. Pregnancy is not subject to this 18-month rule on pre-exisiting conditions, nor are children born or adopted by you, as long as they were covered by a health plan within 30 days of birth or placement for adoption.

Prior Coverage

• HIPPA allows you to use a credit for prior coverage against the pre-existing condition time restrictions. You can reduce the amount of time that pre-existing conditions are excluded by one month for each month that you were covered by a health plan immediately before beginning your new plan. If you were covered for one year prior to joining a new plan, the required wait for a pre-existing condition is reduced by one year, to six months. Consequently, if you have been covered for 18 months, there will be no waiting period for pre-existing conditions. You must not have a gap in coverage between your new and old plans of more than 63 days.

Sharing and Access to Information

• HIPPA has strict controls on the sharing of health care information among different people. This is supposed to help people know how their private health information is being used and know who may have access to this information. Most medical practices require you to sign a disclosure form stating that you understand how information is shared, and naming any specific people that you want to have access to this information. HIPPA provides criminal penalties for people who violate these provisions of the law.

Electronic Records and Infrastructure

• Medical records have been moving to electronic media for storage and retrieval. Many people are concerned that a greater potential exists for unauthorized people to view electronic records or share the information illegally. Health providers have been paying careful attention to how they secure their electronic systems. Engineers make certain that data is encrypted, and strict protections are in place for sensitive data. A correctly engineered system can make data more secure, by only allowing necessary people access to medical data, and monitoring that data access for compliance with HIPPA provisions.