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What is HIPAA? - Definition, Requirements & Laws

What is HIPAA? - Definition, Requirements & Laws
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  • 0:02 HIPAA: Definition
  • 1:30 Title I
  • 2:06 Title II
  • 4:13 Titles III, IV & V
  • 4:59 Lesson Summary
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Instructor: Susan Fenner

Susan has an MBA in Management from the University of North Alabama. She teaches online and campus-based Business courses.

This lesson discusses the United States Health Insurance Portability and Accountability Act of 1996, better known as HIPAA. Let's take a look at the legal protections and administrative requirements of this law.

HIPAA: Definition

Have you ever been asked to sign a HIPAA Privacy Notice form when you've been treated at your doctor's office or in a hospital setting? In general, you may know that HIPAA deals with a patient's right to privacy, but do you have a clear understanding of the protection that it offers as you sign those papers?

Perhaps you're considering changing jobs, but you're concerned about losing your health insurance because you or someone in your family has a chronic illness. Do you know how HIPAA can protect you in this situation?

HIPAA is an acronym that stands for the Health Insurance Portability and Accountability Act of 1996. Developed by the Department of Health and Human services, the primary goals of the Act are:

  1. To provide privacy standards to protect patients' confidential health information and medical records
  2. To make it easier for people to keep their insurance when their employment situation changes
  3. To help the healthcare industry reduce administrative costs

HIPAA is divided into five sections that address different aspects of health insurance reform. The two main sections are Title I, which deals with portability, and Title II, which focuses on administrative simplification. This chart shows the five sections (or titles) of HIPAA.

HIPAA_1996_Chart displaying five sections

Let's take a closer look at some of the basic protection we are afforded under HIPAA.

Title I

Title 1: Portability contains requirements that help people keep their health insurance when they lose or change jobs so they don't have a lapse in coverage. It places limits on exclusions for pre-existing medical conditions and prohibits discriminating against people based on their health status and medical conditions. It also guarantees health insurance policy renewals. In the past, some people were reluctant to change jobs for fear of losing their health care coverage. Thanks to HIPAA, folks in that situation have legal protection.

Title II

Title II: Administrative Simplification includes the privacy rule, which sets standards for the use and disclosure of an individual's protected health information, including our health status, treatment, and payments for healthcare. This applies to all protected health information, including paper copies and electronic data. The privacy rule also gives patients the right to examine and receive a copy of their health records and to request corrections.

Some of the basic administrative requirements placed on health care entities include:

  • Develop a written policy and procedures to protect healthcare information
  • Designate a person to develop the privacy policy
  • Designate a contact person to distribute information and investigate complaints
  • Train the workforce on the policies and procedures
  • Develop procedures for individuals to file complaints about compliance
  • Help lessen any harmful effects caused by disclosure of protected information
  • Maintain reasonable safeguards for protected health information

Under the Administrative Requirements, health care entities are also forbidden to retaliate against people who file a complaint and cannot require anyone to waive their rights under the act.

Title II also establishes uniform standards for transmitting and maintaining healthcare information. It requires all providers to use unique identifiers and encourages them to change from paper records to electronic records to improve security and lower costs.

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