The Health Insurance Portability and Accountability Act of 1996 (HIPAA), was enacted in August 1996.   The Office for Civil Rights (OCR), within the US Department of Health and Human Services (DHHS), has responsibility for implementing and enforcing this law.

The HIPAA Act is comprised of two parts:

HIPAA Health Insurance Reform
Title I of the HIPAA Act protects health insurance coverage for workers and their families when they change or lose their jobs. (i.e. outlines the rules for portability of health insurance)

HIPAA Administrative Simplification (AS)
Title II of the HIPAA Act required DHHS to establish standards for security and privacy of health data, standards for electronic transfer of health care transactions, and standards for national identifiers for providers, health plans, and employers.  Underlying the AS was the national goal to improve the efficiency and effectiveness of the nation's health care system by encouraging the widespread use of electronic data interchange in health care.  Increased use of electronic data has resulted in the need for standards to address patient privacy and security of patients' health information (referred to as Protected Health Information or PHI).

The Privacy Rule of the Administrative Simplification addresses the use and disclosure of PHI.  Who has access to PHI?  And how can a patient's privacy be maintained?

The Privacy Rule requires "covered entities" to make reasonable efforts to protect use and disclosure of "protected health information" (hereafter referred to as PHI). 
"Covered entities" include the following:

• healthcare plans
• medical insurance companies
• healthcare providers (and practices) which transmit any PHI in electronic form

It is important for you to have a very basic understanding of HIPAA and how it impacts your practice of pediatrics.   This module has been created to expose you to some pediatric-specific issues pertinent to HIPAA. 

Join us now on a journey through the world of HIPAA Privacy Regulations.

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last updated 7-30-10