HIPAA MEDICAL PRIVACY - The Big Picture

The Health Insurance Portability and Accountability Act, also known as HIPAA, took effect on April 14, 2003.

HIPAA is about the privacy of medical and health information. More specifically, how this information is processed, protected and handled by health plans, health care providers and others who work with it.

The HIPAA Privacy Rule is a major victory for all health care consumers. It improves the quality of care and access to care by fostering patient trust and confidence in the health care system. People will be encouraged to participate in their own care while public health and research initiatives will benefit from reliable patient data.

Stanislaus County is committed to safeguarding patients' privacy. The County is dedicated to raising the awareness of the importance of ensuring health privacy, in order to improve health care quality and access on both an individual and a community level.

HIPAA has four main provisions:

1. Protects health insurance coverage for workers and their families when changing jobs, this is "portability." If a person has been insured for the past 12 months, a new insurance company cannot refuse to cover the person and cannot impose pre-existing conditions or a waiting period before providing coverage.
2. Protects the privacy of protected health information. The Privacy Rule (PDF Format)  sets standards for how protected health information should be controlled, by setting forth what uses and disclosures are authorized or required and what rights patients have with respect to their health information. The Privacy Rule prohibits the sharing of Individually Identifiable Health Information (IIHI) without a patient's permission unless the purpose of the disclosure is permitted by regulation - such as for treatment, payment or health care operations.
3. Establishes Code Sets (PDF Format)  national standards for the electronic transmission of health information. HIPAA will make sure that the health care industry speaks one common "language" when transmitting claim submissions and remittance advice. This means all doctors, hospitals and clinics in the United States will use one set of diagnostic and billing codes. The goal is to increase the efficiency of electronic claims processing.
4. Establishes Security standards (PDF Format)  for the security of protected health information. The regulations require the adoption of administrative, physical and technical safeguards. The intent is to protect the integrity, confidentiality and availability of electronic protected health information from unauthorized access, alteration, deletion, or transmission. The compliance deadline for the Security Rule is April 21, 2005.