Understanding HIPAA’s Privacy Rule

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The Health Insurance Portability and Accountability Act (HIPAA), pronounced “Hip-Uh,” is a law that was introduced in 1996 to protect patient privacy as well as limit exclusions for pre-existing condition, provide patients with guaranteed renewal of health insurance policies, and require that patients be given the right to continue group health benefits by their group health plan in cases of voluntary or involuntary job loss through COBRA (Consolidated Omnibus Budget Reconciliation Act), among other things.

Among the most important provisions under HIPAA is the Privacy Rule, aimed at protecting patient privacy.

What information is protected under HIPAA’s Privacy Rule?

HIPAA’s Privacy Rule covers “individually identifiable health information held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral,” according to the HIPAA Privacy Rule Summary published by the U.S. Department of Health and Human Services.

In plain terms, this means that health information that identifies an individual, such as health records that contain a person’s name, address, birthdate, social security number, past, present or future health or health-related payment information are covered under the Privacy Rule.

Who is covered under the Privacy Rule?

Individual and group plans that provide or pay the cost of medical care- these include:

  • Health, dental, vision, and prescription drug insurers
  • Health maintenance organizations (“HMOs”)
  • Medicare, Medicaid, Medicare+Choice and Medicare supplement insurers
  • Long-term care insurers
  • Employer-sponsored group health plans with more than 50 employees
  • Government and church-sponsored health plans
  • Multi-employer health plans

Additionally, the following are covered under HIPAA’s privacy rule:

  • Health care providers
  • Health care clearinghouses
  • Business associates and business associate contractors (individuals who are not part of a covered entities workforce, but who perform services for the covered entity that requires the disclosure of health information/records).

A knowledgeable, licensed insurance agent is among your best resources for help understanding HIPAA and how it affects you. For 25 years Benefits Packages has been helping individuals navigate their health insurance options and understand evolving health insurance laws. Visit our website for a quote, or call us at 1-800-356-3615 for assistance today.