HIPAA is an act that was passed by Congress in 1996 with two main parts that are designed to help protect insurance coverage for employees and their families when they lose their job or move to a new one and also helps to prevent insurance fraud and abuse. An added part, known as “The Privacy Rule” was added in 2003 and was designed to regulate the use and disclosure of a patient’s personal information. Everyone who works in the medical and health insurance industries is required to have HIPAA training to be sure they properly understand the HIPAA laws and can properly implement them in their positions.

HIPAA Part I

HIPAA stands for the Health Insurance Portability and Accountability Act. Part I was designed to protect employees from being denied reasonable health care coverage from their employers and includes amendments to several other acts including the Employee Retirement Income Security Act, the Public Health Service Act and the Internal Revenue Code. This portion of the act also helped to protect workers with “pre-existing conditions” from being denied health care coverage. Insurance companies have specific limits they can place on pre-existing conditions, but they cannot deny them coverage indefinitely.

HIPAA Part II

The second part was created to define and regulate insurance fraud and abuse and sets both civil and criminal penalties for people who commit these offenses. It also helped to create ways to simplify the administrative work for the health care industry to help make things more efficient. These changes affect medical billing and insurance workers as well as anyone involved in transferring medical data.

The Privacy Rule

Finally, probably the most well-known portion of the HIPAA act is the Privacy Rule. This portion sets forth the rules about who can and cannot view a patient’s personal medical information and it also requires that each patient signs a statement that indicates that they have received a copy of this information which is why anyone who has been to a doctor’s office has heard of HIPAA. 

Certification

If you are a medical or insurance worker you are required to know and understand the information contained in the HIPAA act. You will need to receive proper training and pass an exam in order to receive a certificate. Since all workers in this industry must have this certificate it is a good idea to get one even if you are applying for a job in the medical or health insurance industries.