1
HIPPA
Jennifer Kennedy
School of Behavioral Sciences, Liberty University
AMAO: Medical Office Ethics and Law
Professor Rebecca Farmer
May 22, 2023
2
HIPPA
The Health Insurance Portability and Accountability Act of 1996 (HIPPA) was signed
into law on August 21, 1996, by then President Clinton. (Caplan, 2003) HIPPA amended
Employee Retirement Income Security Act (ERISA) by guaranteeing renewal and transferability
of health insurance coverage to those who already have coverage and to their dependents. (Flight
and Pardew, 2021) HIPPA contains 5 titles. (Edemekong, 2022)
Title 1: Protects health insurance coverage for workers and their families who change or
lose their jobs. It limits new health plans’ ability to deny coverage due to preexisting
conditions.
Title II: Prevents Health Care Fraud and Abuse; Medical Liability Reform;
Administrative Simplification that requires the establishment of national standards of
electronic health care transactions and national identifiers for providers, employers, and
health insurance plans.
Title III: Guidelines for pre-tax medical spending accounts. It provides changes to health
insurance law and deductions for medical insurance.
Title IV: Guidelines for group health plans. It provides modifications for health coverage.
Title V: Governs company-owned life insurance policies. Makes provisions for treating
people without United States Citizenship and repealed financial institution rule to interest
allocation rules. (Edemekong, 2022)
HIPPA focuses on two main goals, the portability, and the availability aspect. When
HIPPA was passed, Title II, Subtitle F- it intended to standardize and thus simplify electronic
3
data interchange (EDI) for the health care industry. The administrative provisions contain several
mandates to support EDI for health care transactions. HHS initiated 5 rules to enforce
Administrative Simplification: (1) Privacy Rule, (2) Transactions and Code Sets Rule, (3)
Security Rule, (4) Unique Identifiers Rule, and (5) Enforcement Rule. (Williams & Colomb,
2020)
The HIPAA Privacy Rule regulates the use and disclosure of protected health information
(PHI) by “covered entities.” These entities include health care clearinghouses, health insurers,
employee-sponsored health plans, and medical providers. The Privacy Rule requires medical
providers to give individuals PHI access when an individual requests information in writing. A
provider has 30 days to provide a copy of the information to the individual. An individual may
request the information to be delivered via electronic or hard copy. Hospitals may not reveal
information over the phone to relatives of admitted patients. (Miller, 2010)
HIPPA, was enacted into federal law to ensure that patient medical data remains private
and secure. There are two main sections of the law, the privacy rule which addresses the use and
disclosure of individuals' health information, and the security rule which sets national standards
for protecting the confidentiality, integrity, and availability of electronically protected health
information. The privacy rule specifies 18 elements that constitute PHI. These identifiers include
demographic and other information relating to the past, present, or future physical or mental
health or condition of an individual, or the provision or payment of health care to an individual.
(Miller, 2010)
Availability and portability of health insurance are the major underpinnings of this
policy. Availability of health insurance is addressed in 5 major aspects of this policy. The intent
was to make health insurance plans more widely available by eliminating lengthy restrictions on
4
exclusion times for pre-existing conditions and prohibiting the denial of coverage based on pre-
existing conditions. HIPPA prohibits denial of new coverage for pregnant woman, newborns, or
newly adopted children. Another approach to expanding availability was accomplished by
prohibiting employers from excluding an employee or dependent from coverage based on health
status. (Field, 2005)
5
References
Flight, M. R., & Pardew, W. M. (2020). Law, Liability, and Ethics for Medical Office
Professionals. Cengage Learning.
Feld, A. D. (2005). The Health Insurance Portability and Accountability Act (HIPPA):
It’s Broad Effect on Practice. The American Journal of Gastroenterology, 100(7), 1400-1443.
https://doi.org/10.1111/j.1572-0241.2005.50621.x
Miller, J. H. (2010). Sharing clinical research data in the United States under the health
insurance portability and accountability act and the privacy rule. Trials, 11(1).
https://doi.org/10.1186/1745-6215-11-112
Williams, K. J., & Colomb, P. (2020). Important Considerations for the Institutional
Review Board When Granting Health Insurance Portability and Accountability Act
Authorization Waivers. The Ochsner Journal, 20(1), 95-97. https://doi.org/10.31486/toj.19.0083
Edemekong, P. F., (2022). Health Insurance Portability and Accountability Act.
StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/NBK500019
6
