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Health Insurance Portability and Accountability Act (HIPAA)
The Department of Health and Human Services (HHS) published final rules December 13, 2006 to provide guidance for compliance with nondiscrimination provisions of the Health Information Portability and Accountability Act (HIPAA) and the implementation of wellness programs. HIPAA's nondiscrimination provisions generally prohibit a group plan or group health insurance issuer from denying an individual eligibility for benefits based on health factors and from charging a higher premium than a similarly eligible individual based on health factors. Generally these final rules do not change the interim rules published in 2001, but they do clarify how the source-of-injury rules apply to the timing of diagnosis of a medical condition and add examples to illustrate how benefits rules apply. Health factors are identified in the rule as meaning health status; medical conditions (including both physical and mental illnesses) defined in claims experience, receipt of health care, medical history, genetic information, evidence of insurability, or disability. The Employee Benefits Security Administration in the Department of labor has updated their information on frequently asked questions for HIPAA nondiscrimination requirements to assist in compliance of the new rules. The new rules become effective on the first day of the plan year beginning on or after July 1, 2007. For calendar year plans, the new rules apply beginning January 1, 2008.
The Centers for Medicare and Medicaid Services (CMS) is providing consumers and health care providers information on-line that will help unravel some of the complexities related to the national standards established through the Health Insurance Portability and Accountability Act (HIPAA) to protect the privacy of personal health information.
This site also provides links to general information, regulation and standards, HIPAA enforcement and upcoming events. CMS also has a web site with links to HIPAA Online, an interactive tool that helps answer questions about individual rights and protections under the Health Insurance Portability and Accountability Act, and information for employers, state regulators as well as related issues with coverage in self-funded plans and COBRA. This information may be accessed at http://www.cms.hhs.gov/hipaa/hipaa1/default.asp.
The Department of Health and Human Services (HHS) links for information under Medical Privacy-National Standards to Protect the Privacy of Personal Health Information at http://www.hhs.gov/ocr/hipaa/.
Compiled 1/18/07; reposted 2/2/09
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