Tuesday 29 July 2014

What is HIPAA and Why Do I Need to Abide by These Rules and Regulations?

If people have heard of HIPAA or the Health Insurance Accountability and Portable Act of 1996, they probably know that it protects their private medical information. HIPAA actually forced the government to create standards designed to protect personal health care information that is submitted and electronically stored. However, a lot of people do not understand what the law really covers.

What is HIPAA?

The Health Insurance Accountability and Portability Act of 1996 contains five titles. Title One of HIPAA provides health insurance protection for employees and their families when they lose or change jobs.

Title Two of the law, also known as the Administrative Simplification Provisions, created national standards for electronic-based health care transactions and national identifiers for health insurance plans, employers and medical providers. This aims to prevent health care abuse and fraud and provides a platform for administrative simplification and medical liability reform.

Title Three of the law deals with tax related provisions that govern medical savings accounts. It standardizes the amount that a person is allowed to save in their pre-medical savings account.

The law’s fourth title specifies conditions for group health plans that cover people who have a pre-existing condition. It also provides clarification regarding continuation coverage requirements including COBRA.

Title Five contains provisions that are related to company-provided life insurance. It also prohibits the tax reduction of interest on company endowments and life insurance loans or contracts.

Reasons to comply with this Law


There are a number of reasons why people and businesses alike should start complying with this law. HIPAA Omnibus Rule has substantially increased civil penalties for non-compliance. The penalty cap for any violations was increased from $25,000 annually to $1,500,000 per violation.

Aside from that, willfully failing or ignoring to be compliant brings mandatory penalties, and investigations can be started by any discovered violation, breach or complaint.

New Breach Notification Rules

HIPAA rules and regulations now contain new breach notification rules that will increase the quantity of HIPAA violations determined to be breaches. The Omnibus rule has expanded the definition of a breach and the failure consequences. Federal investigations can be triggered when proper notification has been provided.


The Law is Getting Stricter

States are steadily getting more involved in HIPAA enforcement. Failure to comply with HIPAA means feeling the full force of the law. Aside from that, the Office of Civil Rights, a branch of the Department of Health and Human Services, is expanding its Division of Health Information Privacy Information Team. It is stepping up the implementation of HIPAA compliance activities.

Maintains a Company’s Reputation

Complying with this law helps health service providers avoid the HIPAA Wall of Shame. The list of reported major breaches and substantial penalties is growing at a rapid rate.

What is worse is that the details of these breaches are widely available to the general public and reported in the media. The consequences of a data breach can include more than just criminal and civil penalties. They can also damage a company’s reputation.

The Bottom Line

Companies face important obligations under HIPAA. If a company provides services as a health care entity and has not begun the process of implementing a compliance program, the time to take action is now. Although maintaining and achieving compliance is a challenge, a company that fails to act may find that overcoming the consequences of non-compliance presents an even greater challenge.

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