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CODE.MODE

HIPAA

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HIPAA Hippo

This may come as a disappointment, but HIPAA is not slang for an over-sized mammal who entertains us by eating watermelons whole. Instead, HIPAA is the Health Insurance Portability and Accountability Act of 1996, which is US legislation that regulates everything from health care coverage to the protection and handling of private information. HIPAA was enacted by Congress and signed by former President Bill Clinton in 1996,  but it is often known as either the  KennedyKassebaum Act or Kassebaum–Kennedy Act, after two of its leading sponsors. 

HIPAA is divided into Five Titles, which are briefly summarized below. For more information, check out the links provided along the side.   

Health Insurance Portability & Accountability Act

Health Care Access, Portability, and Renewability

TITLE I:

Under Title I, healthcare coverage is protected for workers and their families when the policy holders changes or lose their jobs. Title I further declares that the coverage remains continuous without regard to pre-existing conditions. 

Tax-related Health Provisions Governing Medical Savings Accounts

TITLE III:

TITLE II:

Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reform

Title II is perhaps for what HIPAA is best known: Privacy. This title establishes policies and procedures for protecting the privacy and the security of personally identifiable health information. It also outlines several offenses relating to health care, establishes civil and criminal penalties for violations thereof, and creates several programs to control fraud and abuse within the health-care system.

This title also directly requires the Department of Health and Human Services (HHS) to establish national standards for electronic health care transactions and national identifiers for providers, health plans, and employers. Title II is responsible for the five rules implemented by HHS in regards to Administrative Simplification: 

  • Privacy Rule

  • Transactions and Code Sets Rule

  • Security Rule

  • Unique Identifiers Rule

  • Enforcement Rule

HIPAA's Privacy Rule establishes regulations for the use and disclosure of Protected Health Information (PHI). 

Title III focuses on standardizing the amount that may be saved (per individual) in a pre-tax medical savings account.

TITLE IV:

Application and Enforcement of Group Health Insurance Requirements

Title IV specifies conditions for group health plans concerning coverage of persons with pre-existing conditions. It also modifies and clarifies the requirements for continuation coverage  which includes COBRA clarification.

TITLE V:

Revenue Offset Governing Tax Deductions for Employers

Title IV covers a variety of topics, including provisions related to company-owned life insurance for employers who provide company-owned life insurance premiums. It also prohibits the tax-deduction of interest on life insurance loans, company endowments, or contracts related to the company and repeals the financial institution rule to interest allocation rules. Lastly, Title IV also amends provisions to laws regarding people who give up their US citizenship or permanent residence. 

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