Health Insurance Portability and Accountability (HIPAA)

HIPAA Privacy Rule

The HIPAA Privacy Rule for the first time creates national standards to protect individuals’ medical records and other personal health information.

• It gives patients more control over their health information.
• It sets boundaries on the use and release of health records.
• It establishes appropriate safeguards that health care providers and others must achieve to protect the privacy of health information.
• It holds violators accountable, with civil and criminal penalties that can be imposed if they violate patients’ privacy rights.
• It strikes a balance when public responsibility supports disclosure of some forms of data – for example, to protect public health.

For patients – it means being able to make informed choices when seeking care and reimbursement for care based on how personal health information may be used.

• It enables patients to find out how their information may be used, and about certain disclosures of their information that have been made.
• It generally limits release of information to the minimum reasonably needed for the purpose of the disclosure.
• It generally gives patients the right to examine and obtain a copy of their own health records and request corrections.
• It empowers individuals to control certain uses and disclosures of their health information.

In enacting HIPAA, Congress mandated the establishment of Federal standards for the privacy of individually identifiable health information. When it comes to personal information that moves across hospitals, doctors’ offices, insurers or third party payers, and State lines, our country has relied on a patchwork of Federal and State laws. Under the patchwork of laws existing prior to adoption of HIPAA and the Privacy Rule, personal health information could be distributed—without either notice or authorization—for reasons that had nothing to do with a patient's medical treatment or health care reimbursement. For example, unless otherwise forbidden by State or local law, without the Privacy Rule patient information held by a health plan could, without the patient’s permission, be passed on to a lender who could then deny the patient's application for a home mortgage or a credit card, or to an employer who could use it in personnel decisions. The Privacy Rule establishes a Federal floor of safeguards to protect the confidentiality of medical information. State laws which provide stronger privacy protections will continue to apply over and above the new Federal privacy standards.

Health care providers have a strong tradition of safeguarding private health information. However, in today’s world, the old system of paper records in locked filing cabinets is not enough. With information broadly held and transmitted electronically, the Rule provides clear standards for the protection of personal health information.