::: California Health Insurance Plan Information :::

California Health Insurance Plan Info
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::: California Health Insurance Plan Articles :::



Overview Of The Health Insurance Portability And Accountability Act (HIPAA)

by Malcolm Brown

Congress enacted the Health Insurance Portability and Accountability Act (HIPAA) in 1996. The purpose of this law is to protect private individual health information from being disclosed to anyone without the consent of the individual. Except under unusual circumstances, the consent needs to be in writing.

However, there are some exceptions to the consent provision. The consent provision does not apply in the following situations:

- Treatment
- Billing
- Quality assurance
- Peer review
- Business planning activities
- Staff training
- Required reporting to public health agencies
- Certain emergency situations
- Research studies that have obtained a wavier from the Institutional Review Board (IRB)

Research

Private health information can be used in research studies if it is "de-individualized" so that the identity of the individual cannot be ascertained from the information disclosed. For example, if you were conducting a study of the lung problems suffered by New Yorkers after the 911 terrorist attacks, it would be permissible to identify a patient as, a 50 year old, 5'11', 175 lb., while male from New York City with high blood pressure.

Marketing

Health care providers are prohibited from selling or using their patient or enrollees lists to market products from a third party. However, they can use their list to communicate with or sell their own services to their list members. Great care must be taken to restrict access when using online collaboration, such as an intranet (http://www.trichys.com).

Business Associates

All business associates, vendors or other contractors that use the health care provider's facility must sign a contract stating that they understand and agree to be bound by HIPAA regulations. The health care provider can be held responsible for the actions of the business associate if they did not sign a contract or there was a history of abuse and the health care provider did noting about it.

Individual Rights

Under HIPAA, individuals have the right to:

- Notice of the health provider's privacy practices
- Request restrictions on who is allowed to access their health information
- Access, inspect or copy their personal health information
- Request an accounting of all disclosures of their health information
- Request corrections or amendments to their health information

Health Care Providers Responsibilities

Health care providers are required to:

- Provide security for both paper and electronic individual health information
- Institute a complaint process to investigate complaints
- Train staff on the law

The HIPAA regulations allow for both civil monetary and criminal penalties for violations of the act.


About the Author:

Malcolm Brown is Vice President of Trichys, providers of intranets and extranet solutions for health care and HIPAA compliance (http://www.trichys.com/home/industry-solutions/hipaa.vm).

Source: www.isnare.com


::: California Health Insurance Plan News :::

Yahoo! News
Yahoo! News Search Results for California Health Insurance Plan
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CalPERS: No increase in health premiums (The Sacramento Bee)
15 May 2008 at 7:28am
Gas costs more. So does food. Health insurance? Same thing ? unless you get it through one of the California Public Employees' Retirement System's preferred provider organizations.
CalPERS keeps PPO costs flat (The Sacramento Bee)
16 May 2008 at 12:48pm
CalPERS members who are part of a preferred provider organization won't see an increase in their health insurance premiums next year. In one plan, the costs will drop slightly.
In accord with state, Kaiser to reinstate patients (The Sacramento Bee)
16 May 2008 at 7:23am
The state Department of Managed Health Care and Kaiser Permanente announced an agreement Thursday to immediately reinstate health insurance to 1,092 Kaiser patients in California whose coverage was re...
Kaiser reinstates policies after state intervenes (The Sacramento Bee)
15 May 2008 at 11:02pm
The state Department of Managed Health Care and Kaiser Permanente on Thursday announced an agreement to immediately reinstate health insurance to 1,092 Kaiser patients in California whose coverage was...
Kaiser agrees to offer coverage to 1,000 canceled patients (BizJournals)
15 May 2008 at 8:12pm
Kaiser Permanente has agreed to offer insurance to 1,092 individuals whose policies were inappropriately canceled after they got sick and to refund money paid to the health plan for medical care.
Kaiser, Health Net to reinstate some policies (San Francisco Chronicle)
16 May 2008 at 7:40am
Two health insurers - Kaiser Permanente and Health Net - agreed Thursday to reinstate policies for members who were stripped of their coverage after they incurred medical expenses. Thursday's actions ...
DMHC to announce deal with insurer that rescinded policies (The Sacramento Bee)
15 May 2008 at 12:23am
State regulators are scheduled to announce Thursday "an agreement with a major California health plan to reinstate health coverage immediately to enrollees rescinded of coverage since 2004."
Kaiser patients to receive health coverage again (Orange County Register)
16 May 2008 at 10:13am
The state strikes an agreement with the HMO for patients who were improperly canceled.

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::: California Health Insurance Plan Blogs :::



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