HIPAA - What does it mean?

Thursday, September 23, 2010

In this day of access to a vast wealth of information through the Internet, it is concerning to some that personal privacy may not always be protected.

This issue comes up in workers’ compensation cases regularly, when insurance companies and attorneys request access to information contained in an injured worker’s medical records.

It arises in Social Security Disability cases, because proof of the applicant’s or claimant’s disability must come from medical records spanning often the majority of a person’s lifetime.

In estate planning, access to medical and health records becomes an issue when one decides it is appropriate to give powers of attorney to another person to oversee one’s end-of-life healthcare needs.

In the United States, a series of laws have been enacted to help secure and protect the privacy interests of people seeking healthcare. One such law is the Health Insurance Portability and Accountability Act, or “HIPAA”, which was passed by Congress in 1996. Some of the most relevant portions of the law are explained as follows, courtesy of the US Department of Health and Human Services (HHS) website www.hhs.gov.

Who Must Follow These Laws

We call the entities that must follow the HIPAA regulations covered entities.

Covered entities include:

Health Plans, including health insurance companies, HMOs, company health plans, and certain government programs that pay for health care, such as Medicare and Medicaid.

Most Health Care Providers—those that conduct certain business electronically, such as electronically billing your health insurance—including most doctors, clinics, hospitals, psychologists, chiropractors, nursing homes, pharmacies, and dentists.

Health Care Clearinghouses—entities that process nonstandard health information they receive from another entity into a standard (i.e., standard electronic format or data content), or vice versa.

What Information Is Protected

Information your doctors, nurses, and other health care providers put in your medical record

Conversations your doctor has about your care or treatment with nurses and others
Information about you in your health insurer’s computer system

Billing information about you at your clinic

Most other health information about you held by those who must follow these laws

How Is This Information Protected

Covered entities must put in place safeguards to protect your health information.

Covered entities must reasonably limit uses and disclosures to the minimum necessary to accomplish their intended purpose.

Covered entities must have contracts in place with their contractors and others ensuring that they use and disclose your health information properly and safeguard it appropriately.

Covered entities must have procedures in place to limit who can view and access your health information as well as implement training programs for employees about how to protect your health information.

What Rights Does The Privacy Rule Give Me Over My Health Information

Health Insurers and Providers who are covered entities must comply with your right to:

*Ask to see and get a copy of your health records
*Have corrections added to your health information
*Receive a notice that tells you how your health information may be used and shared
*Decide if you want to give your permission before your health information can be used or shared for certain purposes, such as for marketing
*Get a report on when and why your health information was shared for certain purposes

If you believe your rights are being denied or your health information isn’t being protected, you can
File a complaint with your provider or health insurer
File a complaint with the U.S. Government

You should get to know these important rights, which help you protect your health information.

You can ask your provider or health insurer questions about your rights.

http://www.hhs.gov/o … consumers/index.html

You can learn more about HIPAA in a pdf publication from the HHS, accessible here:

http://www.hhs.gov/o … /consumer_rights.pdf

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