What are the Main Purposes of HIPAA?

The Health Insurance Portability and Accountability Act (HIPAA, as it's more popularly known) is a crucial legislative act that affects healthcare in the U.S. healthcare industry. But what exactly is the goal of HIPAA? Healthcare professionals are often unhappy about the limitations of HIPAA, but are the benefits of the law worth the additional work?

Purpose of HIPAA

HIPAA became law in 1996. In its early form, the law was designed to ensure that workers continued to have health insurance on leave. The law also required healthcare providers to establish safeguards to protect the patient's information to avoid healthcare fraud. However, it took many years for the regulations to be written.

HIPAA also introduced new standards designed to boost efficiency within the healthcare industry. It required healthcare institutions to comply with the latest standards to ease the paperwork burden. Code sets were needed to be used in conjunction with patient identifiers. This allowed the transfer of data from healthcare providers between insurers and healthcare organisations and streamlined the processes of eligibility checks, billing payments, and other healthcare processes.

HIPAA also prohibits tax-deductible interest from life insurance loans, imposes the requirements for group health insurance, and sets the minimum amount of money that can be deposited in a savings account for medical expenses.

HIPAA is a broad legislative act that incorporates the provisions of various other legislative actions, such as the Public Health Service Act, the Employee Retirement Income Security Act, and, most recently, the Health Information Technology for Economic and Clinical Health (HITECH) Act.

Health Data Privacy and Security

HIPAA is now well-known for protecting patients' privacy and ensuring that patient data is adequately secured. These requirements were added to HIPAA's Privacy Rule, the HIPAA Privacy Rule, and the HIPAA Security Rule. The condition of notifying patients of breaches of their health data was established by the Breach Notification Rule in 2009.

The goal of the HIPAA Privacy Rule was to restrict the permitted disclosures and uses of protected health information. It also specifies the circumstances under which they can be contacted and the conditions under which health information may be disclosed. Another critical purpose that was part of the HIPAA Privacy Regulation was to provide patients with access to health information upon request. This HIPAA Security Rule aims to ensure that electronic health information is adequately protected and that access to electronic health records is restricted. An auditable record of PHI activities is kept.

So, in a nutshell, what's the point of HIPAA? to increase health sector efficiency, improve health insurance transferability, protect the privacy of both health plan members and patients, and ensure that health information security is maintained and patients are informed of any breaches to their health information.

FAQs

Why did it take this long to pass between the passing of HIPAA and the release of the Privacy Rule?

When HIPAA was enacted in 1996, the Secretary of Health and Human Services was charged with recommending standards for protecting personally identifiable health data. The recommendations were to be made available to Congress within one year, and if Congress did not pass privacy legislation within three years, the Secretary was to issue an official rule. The rule became known as the "HIPAA Privacy Rule."

The HIPAA Privacy Rule was initially scheduled to be published at the end of December 2000. However, because of the number of complaints expressing confusion about the privacy rule, misunderstandings, and concerns regarding the difficulty of the privacy rule, it was modified to avoid "unanticipated consequences that might harm patients' access to health care or the quality of healthcare" (see 67 Federal Regulation 1475–14815). A substantially revised privacy rule was issued in August 2002.

Why are there different security and privacy rules?

Security Rule The security rule is a subset of the privacy rule in the sense that the privacy rule defines the conditions that permit the divulgence of PHI. The Security Rule details the protocols that must be followed to safeguard electronic PHI against unauthorised uses, disclosures, changes, and deletions. It is important to remember that the Privacy Rule applies to covered entities, while both covered entities and business associates are subject to the Security Rule.

What makes patients need access to their health records?

Healthcare professionals face a high workload that can lead to errors when making changes to patient records. Patients can access their health records and make requests for changes if the data is inaccurate or incomplete. Patients can assume responsibility for their health, and should they want to, they can transfer their health data to a different healthcare provider to avoid repeating tests to determine the diagnosis that is already in place.

How else does HIPAA benefit patients?

Before HIPAA, there were no safeguards in place to protect PHI. The data was frequently stolen to commit insurance fraud and identity theft, affecting patients financially through personal losses, increased insurance premiums, and taxes. Healthcare expenditure per capita in the 1980s and 1990s increased by over 10% each year. In the present, partly because of the measures taken to ensure compliance with HIPAA, the increases in healthcare expenditure per capita are lower than 5% per year.

What were the changes to the Breach Notification Rule in 2009?

The Breach Notification Rule established it as an obligatory legal requirement for covered entities to notify patients when PHI that is not secured is obtained or could be accepted without authorization. The covered entity has to provide specific details about what PHI is being accessed and what steps the patient can take to protect themselves from damage (i.e., cancelling the credit card). If this information is provided in the quickest possible time (the maximum allowed time for this is 60 calendar days), patients can protect themselves from becoming victims of fraud and theft.

Who will enforce HIPAA?

The Department enforces the privacy-related provisions in HIPAA (in Title II) for the Health and Human Services Office for Civil Rights (OCR). HIPAA violations that lead to unauthorised access to PHI are reported to the OCR. The OCR will investigate the matter. Suppose they determine that an infraction of HIPAA was committed. In that case, they will issue a corrective action program, impose a financial fine, or refer the patient for review by the Department of Justice if they believe that criminal activity was involved.

How can HIPAA assist covered entities?

Although HIPAA focuses primarily on patients, it also has advantages for HIPAA-covered entities (health plans, healthcare providers, and clearinghouses for health care). HIPAA has enhanced efficiency by standardizing elements of the administration of healthcare.