The last time you went to the doctor’s office or hospital or had any type of medical procedure for anything, you probably had to sign lots of paperwork. In recent years, federal legislation had added to that growing stack. Now while you’re giving your consent to be treated, promising to pay, and filling in health insurance information, you should also be signing a HIPAA form.
What is HIPPA?
HIPAA is the easy way to say the “Health Insurance Portability and Accountability Act,” a 1996 Congressional mandate that we’re used to thinking is about privacy laws, but was actually designed to prevent abuse, fraud and waste of health insurance, health delivery, and other aspects of health care.
According to the United States Department of Labor, HIPPA has five key parts:
• “Limits the ability of a new employer plan to exclude health insurance coverage for preexisting conditions;
• Provides additional opportunities to enroll in a group health insurance plan if you experience certain life events or lose other health insurance coverage;
• Prohibits discrimination against employees and dependent family members based on any health factors they may have, including prior medical conditions, previous claims experience, and genetic information; and
• Guarantees certain individuals will have access to, and are able to renew individual health insurance policies.”
What are the Privacy Laws?
The privacy law portion of HIPPA basically means that you have federal protection that covers your healthcare information. Privacy and security rules are designed to make sure that healthcare disclosure is done appropriately. The laws say that you have the right to access and copy your own health records, that you have the right to know who sees your health information, and you can choose which friends or family members (if any) are allowed to have information on your condition.
What if HIPPA isn’t followed?
It’s not a foolproof system. Nothing is. But, it does make it less likely that your healthcare information will be shared with people who aren’t supposed to know. But what do you do if a healthcare provider doesn’t honor the HIPAA regulations? Do you have any recourse?
Absolutely! Anyone can file a complaint. The rules are pretty simple. The department of Health and Human Services has a prepared complaint package ready for you to download and use. You can’t just call it in.
You have to fax, write or email the complaint, you only have 180 days in which to do so, and in your complaint, you need to name the person (or business) that violated your rights and how exactly they did so. If you need help and you want to file a complaint or if have any questions about the available complaint or consent forms, please e-mail the Office of Civil Rights at OCRMail@hhs.gov.
However, it is important to note that these rules do not provide an opportunity to sue over violations. The Department of Health does have the power to fine the offending entity up to $250,000.
Understanding HIPPA
Because HIPPA represents a national standard for health care information, everyone who works in the health care field who has access to patient data must become very familiar with these laws. Failure to do so can jeopardize one’s employer’s business and therefore, your own job. In addition, HIPPA questions are often included in medical coding certification exams, and you will need to be prepared to respond appropriately.
Resources
Department of Labor overview of HIPPA
http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html
HIPPA Violation of Right Complaint Package
http://www.hhs.gov/ocr/privacy/hipaa/complaints/hipcomplaintform.pdf
Angie Boss is an award-winning health industry writer and author or co-author of several books, including Before Your Time: Living Well with Premature Menopause (Simon and Schuster, 2010). She received a Bachelor's of Arts degree in Sociology and Journalism from Virginia Wesleyan College and a Masters of Pastoral Counseling from Union Theological Seminary.
