The Meaning of HIPAA: What It Is and How To Use It

You might see the term HIPAA floating around thanks to recent vaccine regulations and healthcare requirements, but what is the meaning of HIPAA?

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In the United States, several laws protect peoples’ data privacy, and HIPAA is one of them. This article will examine what kind of information is protected under HIPAA and how HIPAA functions. After you read this article, you shall know everything there is to know about HIPAA, according to the CDC and the National Institute of Health.

What Does HIPAA Mean?

HIPAA stands for The Health Insurance Portability and Accountability Act of 1996. Bill Clinton passed this federal law to override state laws about the safety of medical information unless they are stricter to safeguard medical information. This law is also known as Public Law 104-191.

HIPAA also aims to reduce the cost of healthcare through standardizing the way administrative and financial transactions are electronically transmitted, providing health insurance coverage for people who lose or change jobs, and preventing health insurance and healthcare delivery fraud, abuse, and waste.

The Office for Civil Rights (OCR) is responsible for enforcing HIPAA. This office can audit electronically protected health information, patient health information, and personal health information (PHI/EPHI) like medical records. It can also investigate insurance companies and healthcare organizations. The OCR implements several physical and technical safeguards to protect against noncompliance with disclosing protected health information.

What Are the Components of HIPAA?

There are five different titles within HIPAA that each has its own aim. Title I is known as the HIPAA Health Insurance Reform section, which helps insure people who have lost or changed their jobs, and disallows group health plans from denying coverage to people with preexisting conditions. 

Title II is known as the HIPAA Administrative Simplification, which requires the U.S. Department of Health and Human Services (HHS) to create standards by which companies process electronic healthcare transactions that comply with certain privacy regulations and an individual’s right to their information. 

Usually, when people refer to HIPAA compliance, they refer to Title II at the HIPAA Privacy Rule, HIPAA Security Rule, HIPAA Enforcement Rule, Transactions and Code Sets Standard, and National Provider Identifier Standard.

Title III, the HIPAA Tax-Related Health Provisions, sets out tax guidelines for types of medical care. Meanwhile, Title IV continues to reform health insurance by setting out group health plan requirements. Finally, Title V covers revenue offsets for company-owned life insurance.

What Information Does HIPAA Protect?

A lot of personal information is protected under HIPAA, like peoples’ names, dates of birth, Social Security numbers, and other PII or personally identifiable information. Additionally, HIPAA protects information about a patient’s care, such as their physical and mental health condition or any services that have been rendered to a patient. 

What Entities Are Covered by HIPAA?

Several types of entities fall under HIPAA and must comply with HIPAA’s rules and regulations. First, healthcare providers such as doctors, nurses, dentists, clinics, chiropractors, pharmacies, and mental health professionals are responsible for HIPAA compliance. Additionally, healthcare clearinghouses fall under the same jurisdiction.

Health insurance plans and other health plans also fall under HIPAA. These can include government healthcare programs like Medicaid, Medicare, and others. It also includes private health insurance companies and health maintenance organizations.

Often, organizations undergo training to ensure they do not violate HIPAA or the Health Information Technology for Economic and Clinical Health or HITECH Act.

If these companies break the HIPAA privacy rules, they can be subject to several fines. Unknowing HIPAA violations cost $100 per violation up to $25,000 per year. Reasonable cause violations cost $1000 per violation up to $100,000 per year. 

Willfully neglecting HIPAA but correcting the violation costs $10,000 per violation up to $250,000 per year. Finally, willfully neglecting HIPAA and not correcting the violation costs $50,000 per violation up to $1.5 million per year.

What Is the HIPAA Omnibus Rule?

The HIPAA Omnibus Rule is an amendment to the original HIPAA Act due to the HITECH Act. This rule made many amendments to HIPAA to strengthen privacy and security protections and imposed many restrictions on how entities share information. 

When Can Entities Share Private Information?

There are several circumstances in which entities might need to share information, and HIPAA protects this sharing. First, entities can share information with the information’s subject. Information can also be shared if the individual gives the entity express permission to share this information with a specific person, such as an emergency contact. Finally, information can be shared if information needs to be shared with a different entity for healthcare, payment, and treatment options.

Entities also can share information for a total of twelve different so-called “national priority” purposes, which include the following:

  • For worker’s compensation
  • For government functions
  • To prevent threats to the health and safety of others
  • For research purposes
  • For the cadaveric donation of tissues, eyes, and organs
  • For identification of deceased people
  • For law enforcement purposes
  • For health oversight
  • For abuse, neglect, or domestic violence victims
  • For administrative or judicial proceedings
  • When required by law

Conclusion

HIPAA is a public health law responsible for making sure health care providers and insurance companies meet national standards for the protection of identifiable health information, healthcare data, and electronic health records. The OCR is responsible for investigating HIPAA violations. 

Do you think that entities should have the right to share a person’s private information, or do you think the individual should control who gets their information and why? 

Sources:

  1. Health Insurance Portability and Accountability Act of 1996 (HIPAA) | CDC
  2. What is HIPAA (Health Insurance Portability and Accountability Act)? | Tech Target  
  3. Health Insurance Portability and Accountability Act – StatPearls – NCBI Bookshelf | NIH