The Health Insurance Portability and Accountability Act of 1996 was enacted by the 404th United States Congress. It was created to protect individuals who need to change health insurance plans or providers due to changing health conditions or circumstances. It also encourages health insurance providers to allow change, regardless of whether the individual had coverage at the time the change takes effect. The Act is important for people who purchase insurance on their own and for employers who provide insurance to their employees. It encourages insurance companies and providers to cooperate with each other to provide adequate health insurance to all Americans. There are three main provisions under the Act that directly affect the insurance industry and health care providers.
The Act requires that all health insurance contracts are legally enforceable. It also requires all private health information technology systems to maintain certain standards of security. It also requires providers of health insurance to take measures to mitigate against unintentional disclosure of patients' health information to third parties. The Act also encourages companies and providers to work together to promote better patient care. One provision requires health information technology to periodically review security programs and recommend appropriate upgrades.
Both the health insurance portability and accountability act encourages providers and employers to consider electronic patient records (EPRS) a part of their EHBS or preferred provider organizations. Electronic health care records can include more than just date of birth or illness but can include a full medical history, discharge summary, surgical procedures, outpatient medication history, health plan documents, insurance claims, physician communications, and much more. The Health Insurance Portability and Accountability Act also encourage health care providers and carriers to use EHRs to provide accurate and current health care records to patients.
Another provision of the health insurance portability and accountability act requires healthcare providers who do not use EHRs to give notice to patients and provide privacy protection protections. Healthcare providers are also required to update and make available to patients about their privacy security protections at least once each year. This is done through an Affidavit of Privacy Protection. Providers who fail to comply with this requirement may be subjected to fines.
An employer who does not have an EHR will still be required by law to provide employees access to their EHR. Employees may be required to designate a primary health care provider. EHR vendors must provide designated individuals with up-to-date, comprehensive health care reports on their health insurance coverage, including their Medicare and Medicaid coverage. The act also requires EHR vendors to provide notice of changes in policy, and procedures for choosing and purchasing health insurance, as well as how to cancel or change health insurance.
There are numerous regulations regarding health insurance portability and accountability, including definitions of terms, the rules for opting out of EHRs, and the reporting requirements. Each of these areas is the subject of a wide variety of State and Federal rules. Each year, numerous changes to the health insurance portability and accountability act are made in attempts to improve these systems.