The Health Insurance Portability and Accountability Act of 1996, or HIPAA as it is more commonly referred to, was mandated by Congress and is currently enforced by the Department of Health and Human Services. This legislation was mandated in direct response to protect the privacy and security of patient medical information. It also attempts to standardize electronic transaction submittals such as medical insurance claims. Because of the complexity of the language it uses, HIPAA can often be misinterpreted by healthcare professionals and patients alike. To demystify this legislation's intent, we have prepared a brief synopsis of the act's purpose.
First, HIPAA attempts to set a national standard for accessing and handling health records. Next, the act allows individuals easier access to their own medical information. Before the acts creation, access was not mandated and only half of the states created legislation that addressed this issue. Third, the act guarantees a notice of privacy practices in that it protects how your medical information is used by medical practices and its uses disclosed to its patients. Consequently, the act also mandates an accounting of disclosures for the prior six years. Also, patients are granted the right and means to file a complaint with your healthcare provider and/or with the Department of Health and Human Services if it is believed that their patient rights have been violated. Another right guaranteed by HIPAA is the ability to make special requests for confidentially communicating health announcements using an alternative method if preferred. Some additional legislative requirements include staff training, the appointment of a privacy officer, and the establishment of other formal safeguards. HIPAA also authorizes heavy civil and criminal penalties if its requirements are violated in anyway.
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Admirably, HIPAA attempts to address health care access, portability, renewability, eliminating fraud and abuse, and medical liability reform under one sweeping legislative act. However, HIPAA's shortcomings are debated at length by both medical practitioners, lawmakers and patient rights advocates. For instance, patient consent is not required if its use is first disclosed. Although this makes sense in times of emergency, it is a severe breach of patient confidentiality when, for example, a patient's physician bills for a service rendered that the patient intended to pay for themselves because they were uncomfortable with sharing the information with their carrier. Another concern is that past medical history can be shared even when the patient assumed the old information was no longer available for public consumption. Additionally, a patient's information can be used for marketing purposes without their consent. Also, although the patient can file a complaint, the patient's right to sue has been eliminated by HIPAA. HIPAA also allows a medical practitioner to share a patient's medical information with business associates such as billing services, lawyers, accountants, data processors, and software vendors. Lastly, law enforcement maintains unprecedented access of patient records. In fact, some patient information can be shared with law enforcement officials without a warrant or patient disclosure.
HIPAA intentions were and are good but the scope of the Act is enormous and does not always protect patients as intended. With healthcare legislation being address at the Congressional level, expect changes to HIPAA while maintaining the basic privacy rights of patients.
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