Chapter 2: HIPAA In Plain English

OVERVIEW

The Health Insurance Portability and Accountability Act (HIPAA) had an auspicious beginning. Technological innovations were beginning to enable hospitals , laboratories, and other health care providers to process a person's health information with greater efficiency and improve health care delivery services. These innovations also had some untoward effects. An individual's electronic medical records could be used without an individual's knowledge or consent . There were no standardized transaction and code sets between providers. This made it difficult for providers to exchange information for treatment and payment. Individuals did not know who had access to their health information and to whom providers gave this information. In addition, no standard existed to address how to secure health care information.

The public began to demand greater control over who had access to their health information and the conditions for using this information. The Kennedy-Kassenbaum/Kassenbaum-Kennedy Bill sought to address the public's demands. President Clinton signed the bill into law on August 21, 1996 as the Health Information Portability and Accountability Act or [H.R.31303] Public Law 104-107, commonly called HIPAA.

HIPAA is a substantial piece of legislation impacting all facets of the health care industry. The HIPAA regulation is broken into five parts or titles with the following goals:

• Title I Portability

  Ensure the portability and continuity of health insurance when an individual changes employers

• Title II Administration Simplification

  Protect the health insurance and health care delivery systems from fraud and abuse through administrative simplification.

• Title III Tax Benefits

  Promote medical savings through tax- related health provisions

• Title IV Group Health Insurance

  Specify group health insurance requirements

• Title V Revenue Offsets

  Define revenue offsets