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What Is Comprehensive Medical Insurance? Congress approved the Health Insurance Portability and Accountability Act HIPAA to guard the privacy of personal medical information, and to give individuals the right to keep their health insurance coverage for pre-existing conditions in place even if they change jobs.
The law has done this, providing important safeguards for patients. But it has also increased the red tape involved in medical care. Department of Health and Human Services finalized standards for the electronic exchange, privacy and security of health information in The rules apply to health plans, health care clearinghouses, and to any health care provider, such as a doctor, who transmits health information in electronic form.
Any entity, including a physician's office, a hospital or other health care facility, or an insurer, that deals with personal health information must follow strict rules about how to handle that information to avoid disclosing it to someone not authorized to see it.
For example, Health and Human Services allows physicians and insurance companies to exchange individually identifiable health information to pay a health claim, but would not allow them to release it publicly.
Minimum Necessary According to Health and Human Services, the privacy rule also requires physicians, hospitals, insurers, and other health care entities to use and disclose only the minimum amount of information needed to complete the transaction or fulfill the request.
As a practical matter, for example, that means a physician should not send a patient's entire medical file to an insurer if just one page from the record will suffice to answer the insurer's query. Portability In addition to protecting patients' privacy, HIPAA also limits the ability of a new employer plan to exclude coverage for pre-existing conditions.
This means a person who has health insurance coverage can change jobs -- and therefore health plans -- without worrying that a condition they already have, such as diabetes or asthma, would not be covered under the new health plan.
This was not always the case, according to the U. HIPAA also prohibits discrimination against employees and their family members based on health histories, previous claims, and genetic information, according to the Department of Labor.
It also prevented employers from accessing and using personal health information to make employment decisions. And, it enabled patients with pre-existing conditions to change jobs without worrying that their conditions would not be covered under a new employer's health plan.
The regulations increased the paperwork burden for doctors considerably, according to the American Medical Association.
HIPAA has spawned a mini-industry of companies and consultants who help medical professionals comply with the law's lengthy provisions.
In addition, some professionals who deal with medical paperwork have become overcautious about releasing protected information. For example, some physician's offices now refuse to mail test results, saying patients need to pick them up in person.
And some hospitals require physicians to submit written requests on their own letterhead for information on a patient's condition, when the law allows this information to be provided by phone.Although certain government programs that fund providers directly may not be health plans, government programs that reimburse providers or otherwise fund providers to perform direct health-care services should carefully analyze the details of their programs to determine if they are performing covered functions.
The HIPAA rule defines seven patient rights, one of them is a right to request amendment. This page includes all FAQs explaining this right (FAQ ) On our list, the right to request an amendment of your health record is only the fourth right out of seven. Although certain government programs that fund providers directly may not be health plans, government programs that reimburse providers or otherwise fund providers to perform direct health-care services should carefully analyze the details of their programs to determine if they are performing covered functions.
HIPAA legislation is national in scope“, sweeping in its coverage, and far-reaching in its implications, and thus concerns a wide range of stakeholders.”. A few argued that the provision should be time-limited, e.g., that covered entities should not have to amend protected health information that is more than two years old.
Other comments suggested that the provision should only be applied to protected health information created after the .
• Providers should ensure that staff understand that erring too much on the side of caution can have negative effects. Healthcare providers have spent years grappling with how to comply with the Health Insurance Portability and Accountability Act (HIPAA), with most of the focus on training clinicians and staff about the dangers of too freely.