Health insurance portability act

The Health Insurance Portability and Accountability Act (HIPAA) was adopted in 1996 by the Congress of United States. Referring to the Centers for Medicare and Medicaid Services website, Title I of HIPAA was made to protect health insurance coverage, for workers and their families in case they switch or lose their jobs. Second Title of Health Insurance Portability and Accountability Act, better known as Administrative Simplification provisions, forced the organization of national principles for electronic health care transactions, insurance policies, and employers.

The Administrative Simplification provisions also increases the protection and confidentiality of health data, left by insurance holders. These standards are designed to advance the effectiveness and value of the health care system in the country. They widely encourage electronic data interchange inside the national health care system.

In fact, title I puts limits on certain restrictions. For example, group health insurance can not place restrictions on benefits for people that have pre-existing conditions. Group health insurance policies may reject the provision of benefits, relating to pre-existing conditions for a 12 months period after obtaining the plan, or 18 month period, in case of late enrollment. Individuals that had health insurance plans before can reduce the exclusion period.

Title I exempts some health insurance plans, such as long-term health plans and limited-scope plans. For example, such plans as dental or vision plans that are usually offered separately from general health care. Nevertheless, if these benefits are considered to be a part of general health plan, Health Insurance Portability and Accountability Act applies to them.

Title II of the Health Insurance Portability and Accountability Act outlines special offences that relate to health care and defines criminal and civil punishment for them. Those rules have significantly decreased the number of unfair health insurance companies and agents. People do not have to be afraid to obtain the health insurance, because they are protected by law.

As we have already mentioned above, title II of Health Insurance Portability and Accountability act has a special Privacy Rule. It started acting on April 14, 2003. It worked out a policy for the usage and disclosure of PHI (Protected Health Information). What is PHI? It is any information about health conditions, health care, health history, or any data on expenses that can be applied to an individual. Covered entity has to disclose PHI to the person within 30 days after request was made. The Privacy Rule requires covered entities to take rational steps to ensure the privacy of communication with an individual. For example, a person may request to be called at his/her work number instead of home or cell phone number.

If you doubt that Privacy Rules have been upheld and think that your information is not secured, you can complain to the Department of Health and Human Service Office for Civil Rights. However, people say that OCR has a huge backlog and ignores most of the complaints. Health Insurance Portability and Accountability Act has made a significant contribution to the health insurance system in the USA.