The Health Insurance Portability and Accountability Act (HIPAA) is a US federal law that was enacted in 1996. The law includes provisions to improve the portability and continuity of health insurance coverage, as well as to protect the confidentiality and security of health information.
HIPAA applies to all entities that are considered “covered entities” under the law, which include health care providers,health plans, and clearinghouses. The HIPAA Privacy Rule establishes national standards for the protection of personal health information, while the HIPAA Security Rule sets standards for electronic protected health information.
Both covered entities and their business associates must comply with the requirements of HIPAA. Violations of HIPAA can result in civil or criminal penalties.
The major debates in the healthcare reform realm during this period were how to increase accessibility to healthcare and deal with significant administrative issues throughout the sector (AMA 2011). In order to combat several problems at once, Congress established and passed the Health Insurance Portability and Accountability Act (HIPAA) in 1996.
The hope was that by providing Americans with portable health insurance, they would no longer have to worry about losing coverage if they changed jobs. In addition, Congress also wanted to establish national standards for electronic health care transactions and data privacy (U.S. Department of Health and Human Services, 2013).
The Health Insurance Portability and Accountability Act is a federal law that sets standards for the handling of sensitive patient information by covered entities, which include healthcare providers, health plans, and clearinghouses. The act’s privacy rule establishes national standards to protect individuals’ medical records and other personal health information and applies to all forms of protected health information, whether electronically stored or maintained in paper records (U.S. Department of Health & Human Services, n.d.-a).
The security rule is a federal law that requires covered entities to take steps to protect the confidentiality, integrity, and availability of electronic protected health information (e-PHI). The security rule establishes three types of safeguards: administrative, physical, and technical. Administrative safeguards are the policies and procedures put in place by a covered entity to protect e-PHI and manage the conduct of its workforce.
Physical safeguards are measures taken to secure a covered entity’s premises and equipment so that only authorized individuals have access to e-PHI. Technical safeguards are the technology and security measures used by a covered entity to access, transmit, and store e-PHI (U.S. Department of Health & Human Services, n.d.-b).
The Health Insurance Portability and Accountability Act not only sets standards for how patient information can be handled, but also outlines penalties for covered entities that do not comply with the law. The Department of Health and Human Services’ Office for Civil Rights is responsible for investigating complaints and enforcing HIPAA (U.S. Department of Health & Human Services, n.d.-c).
HIPAA has been successful in its goal of protecting patient information and establishing national standards for electronic health care transactions. However, the law is not without its critics. Some say that the administrative burden placed on covered entities is too great, while others argue that the privacy rule does not do enough to protect patient information. Nonetheless, HIPAA remains the law of the land and covered entities must take steps to ensure they are in compliance.
The enactment of HIPAA resulted in a greater need for transparency within the healthcare system. HIPAA changed the landscape of fraud control in two major ways; by increasing penalties and federal oversight for most laws related to healthcare fraud, and by creating incentives for healthcare organizations to comply with the new regulations (Hyman, 2002).
The new law also created the Health Care Fraud and Abuse Control Program, which is designed to reduce the fraudulent billing practices within the healthcare system.
HIPAA has been successful in reducing fraud and abuse in the healthcare system. In its first year of operation, the Health Care Fraud and Abuse Control Program saved the government $1.6 billion dollars (Hyman, 2002). This savings is a direct result of the increased accountability that HIPAA requires from healthcare providers.
Despite its successes, HIPAA has been criticized for being too complex and for creating burdensome paperwork requirements for healthcare providers. Critics have also raised concerns about the potential for abuse of the personal health information that is protected under HIPAA (HIPAA Privacy Rule, 2016).
The act contains statues that protect the privacy and confidentiality of healthcare information. The right to privacy is commonly referred to as a patient’s right to be left alone (McWay, 2008). A patient’s right to privacy is not only protected by HIPAA but also by constitutional, statutory, and common law provisions.
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that protects the confidentiality of patient health information. HIPAA applies to all forms of health care, including but not limited to hospitals, clinics, pharmacies, and insurance companies. The act contains strict provisions on the use and disclosure of protected health information (PHI).
PHI is any information that can be used to identify an individual, such as a person’s name, address, Social Security number, or date of birth. HIPAA also requires covered entities to take reasonable steps to protect PHI from unauthorized access, use, or disclosure.
Under HIPAA, covered entities are required to provide patients with notice of their privacy rights and explain how their PHI will be used and disclosed. Patients have the right to request restrictions on the use and disclosure of their PHI, and they also have the right to receive confidential communications from their health care providers. Covered entities are required to maintain records of their privacy practices and make these records available to patients upon request.
HIPAA has been enforced by the U.S. Department of Health and Human Services (HHS) since its enactment in 1996. HIPAA violations can result in civil or criminal penalties, including fines of up to $50,000 per violation and imprisonment for up to 10 years. The HHS Office for Civil Rights (OCR) is responsible for investigating complaints of HIPAA violations.
The HIPAA Privacy Rule establishes national standards to protect individuals’ medical records and other personal health information and applies to health plans, healthcare clearinghouses, and those healthcare providers that conduct certain transactions electronically. The Privacy Rule requires covered entities to provide individuals with notice of their rights under HIPAA and sets forth standards for the secure handling of PHI.
The HIPAA Security Rule establishes national standards to protect the confidentiality, integrity, and availability of electronic protected health information (EPHI). The Security Rule requires covered entities to take reasonable steps to safeguard EPHI from unauthorized access, use, or disclosure. Covered entities must also ensure that their business associates take reasonable steps to protect EPHI.
The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009 (ARRA), strengthens the privacy and security protections established by HIPAA. The HITECH Act also promotes the adoption and meaningful use of health information technology, such as electronic health records (EHRs).
The HITECH Act requires covered entities and their business associates to provide notification to individuals when their PHI has been breached. A breach is defined as the unauthorized acquisition, access, use, or disclosure of PHI that compromises the security or privacy of the information. Covered entities must also notify the HHS Office for Civil Rights (OCR) of any breaches that affect 500 or more individuals.