Illinois HIPAA Requirements

With identity theft and computer hacking on the rise, precautions need to be taken to keep particular information private. Federal law protects the privacy of personal information when it's submitted through health insurance claims. The Health Insurance Portability and Accountability Act (HIPAA) sets standards for this privacy protection.



Federal laws take precedence except in cases where state laws are stricter. In Illinois, there are certain requirements in addition to HIPAA stipulations.

Protected Health Information

• The specific information that needs to be protected is considered protected health information, more commonly known as PHI. More healthcare providers are submitting their claims electronically, which poses a threat if a patient's information falls into the wrong hands. PHI is any information that directly identifies an individual. Information that's considered PHI includes, but is not limited to, name, Social Security numbers, birth date (except for the year), email addresses and home addresses. PHI is also considered information unique to the health insurance claim itself, such as the claim number and the health plan beneficiary number.

  The laws also allow people to be informed about how their PHI can be used. Privacy rules protect a person's PHI by restricting any identifiable information. This information relates to all past, present and future physical ailments, the provision of healthcare to an individual and the payment for these proceedings.

Preexisting Conditions

• According to the Illinois Department of Insurance, HIPAA guidelines also protect people who have preexisting conditions. The law protects benefits by limiting exclusion periods, provides protections when a patient changes jobs, allows special enrollment rights for the patient and any dependents for certain circumstances, and guarantees access to individual coverage through the Illinois Comprehensive Health Insurance Plan, or CHIP. CHIP is ideal for an individual who is unable to buy traditional health insurance because he's considered a high-risk customer due to his current health state or his past medical conditions.

Confidentiality

• Individuals who work every day around other people's private information are required to be cautious with the information they're privy to. People who work in the healthcare industry and the insurance industry must have a general understanding about PHI and the different ways to protect this information. Employees of health insurance companies are required to pass an exam quizzing them on basic HIPAA regulations.

  HIPAA also requires that mandated safeguards are put into place so that employees who work with PHI can store and maintain the information properly. Any information that contains PHI must be maintained and transmitted in a safe environment, and any information that needs to be discarded has to be disposed of in accordance to HIPAA regulations.