HIPAA 101

Learn about the
Health Insurance Portability
and Accountability Act

HIPAA is the acronym for the Health Insurance Portability and Accountability Act that was passed by Congress in 1996.  HIPAA does the following:

  • Provides the ability to transfer and continue health insurance coverage for millions of American workers and their families when they change or lose their jobs;
  • Reduces health care fraud and abuse;
  • Mandates industry-wide standards for health care information on electronic billing and other processes; and
  • Requires the protection and confidential handling of protected health information

HIPAA is organized into separate “Titles.” Below we dive into each one quickly

HIPAA TITLES

Title I:  HIPAA Health Insurance Reform

Title I of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects health insurance coverage for workers and their families when they change or lose their jobs. Similar to how COBRA used to work.

Title II:  HIPAA Administrative Simplification

Requires the Department of Health and Human Services to establish national standards for electronic health care transactions and national identifiers for providers, health plans, and employers as well as addresses the security and privacy of health data.

The U.S. Department of Health and Human Services (DHHS) develops and publishes the rules pertaining to the implementation of HIPAA and standards to be used.  All health care organizations impacted by HIPAA are required to comply with the standards or face stiff penalties.

Title III:  HIPAA Tax Related Health Provisions

Provides for certain deductions for medical insurance, and makes other changes to health insurance law.

Title IV:  Application and Enforcement of Group Health Plan Requirements

Specifies conditions for group health plans regarding coverage of persons with pre-existing conditions, and modifies continuation of coverage requirements.

Title V:  Revenue Offsets

Includes provisions related to company-owned life insurance, treatment of individuals who lose U.S. Citizenship for income tax purposes and repeals the financial institution rule to interest allocation rules.