What Does HIPAA Stand For?

HIPAA is over 20 years old; However, many patients and providers still misunderstand it. As a result, they even misspell HIPAA as HIPPA. Google stats show over 350,000 monthly searches for “HIPPA,” almost as many as “HIPAA.”

A simple Google search for “HIPPA” returns over 3 million results, including articles on legal and healthcare provider websites, which accounts for approximately 10% of total search results for HIPPA and HIPAA combined.

A lack of basic knowledge of HIPAA has resulted in over 24,825 corrective actions by OCR in HIPAA cases since 2003. Security breaches plague the healthcare industry. In the three months of 2016 alone, 25 million patient records were compromised.

So why is it HIPAA and not HIPPA, and what does it stand for?

HIPAA is the acronym for Health Insurance Portability and Accountability Act of 1996. Senators Ted Kennedy and Nancy Kassebaum first introduced the legislation that serves as the foundation of HIPAA. The goal of HIPAA was to amend the Internal Revenue Code of 1986 to improve the portability of health insurance, simplify its administration, and prevent fraud and abuse in the health care system.

As a result, HIPAA improved health insurance accountability and provided coverage for those with pre-existing health conditions. In addition, confidentiality systems have been put in place to keep protected health information private.

HIPAA enforcement for most insured companies did not begin until April 14, 2003, while it did not begin until April 2004 for smaller health insurance companies.

HIPAA Summary

As we mentioned earlier, the main purpose of HIPAA was to help employees maintain their health insurance. However, another goal of HIPAA is to improve the effectiveness of the healthcare system through administrative simplification.

On the other hand, the HIPAA Privacy Rule of 2003 and the HIPAA Security Rule of 2003 introduced security requirements. They enforce patient privacy by ensuring patient data is secure.

HIPAA consists of five “titles,” each covering a different aspect of the law:

  • Title I includes health insurance reform and includes access to group insurance plans for employees and their families. This title dictates that a group insurance plan cannot set the monthly premium amount or deny coverage based on medical condition. It also regulates the protection of insurance cover in the event of a job change or job loss.
  • Title II HIPAA focuses on preventing healthcare fraud and consists of five main rules: Privacy Rule, Transactions and Codesets Rule, Security Rule, Unique Identifiers Rule, Enforcement Rule. Title II is the most well-known part of HIPAA and covers various aspects of privacy. It describes the safeguards (administrative, physical and technical) required to protect PHI from unauthorized access. The enforcement rule further protects patient privacy by introducing financial and criminal penalties for non-compliance.
  • Title III establishes tax health regulations. This title describes savings in a pre-tax medical account. The main highlight of Title III is that it gives both self-employed and employees access to a medical savings account.
  • Title IV Clarifies Continuation of Health Insurance (COBRA) and strengthens Title I provisions on continuation of health insurance in the event of job change or loss and coverage for those with pre-existing medical conditions.
  • Title V of the HIPAA Act was introduced in response to widespread leveraged company-owned-life insurance (COLI). It prohibits deductions for interest on business loans for life insurance. However, it grants a $50,000 loan waiver for policies covering the lives of key employees. In addition, Title V contains provisions relating to estate, income, and gift taxes for persons who lose US citizenship.

Why is HIPAA important?

Understanding HIPAA is critical for both healthcare organizations and patients.

Why is HIPAA important for healthcare organizations?

HIPAA regulations improve data systems and encourage healthcare organizations to adopt more efficient technologies that improve the quality and efficiency of patient care. By understanding and preventing security risks through the establishment of robust policies and procedures, organizations can focus on their operations and profits.

Additionally, by introducing standardized code sets and nationally recognized identifiers, HIPAA improves the efficiency of the entire health care system by simplifying the transmission of electronic health information between health insurance companies and health care providers.

Aside from reducing risks to the security and integrity of patient data and other HIPAA compliance benefits, non-compliance with HIPAA can impose a severe financial burden, with penalties for violations of up to $1.5 million per incident can.

Why is HIPAA important for patients?

HIPAA ensures that affected companies implement policies and procedures to protect confidential health information. Without HIPAA, organizations would face no consequences for not protecting data.

Educated patients can help the healthcare industry secure and manage their healthcare data more efficiently. Patients have more control over who their information is shared with.

They may receive copies of their records to verify their health information and to help healthcare providers keep records accurate. On the other hand, obtaining copies of health information allows patients to seek treatment from new health care providers. The smooth transfer of data allows patients to avoid repeat testing and provides new healthcare providers with the complete patient history to make informed decisions.

Final Thoughts

HIPAA may seem complicated and difficult to understand; However, it brought numerous benefits to patients and healthcare organizations.

It reduced healthcare paper, introduced data standardization, and enforced common filing and reporting practices across the healthcare industry. HIPAA promotes a culture of compliance and encourages every member of a healthcare organization to protect patient privacy and safety.

Before the introduction of HIPAA, individual companies practiced uncoordinated and complicated methods of managing medical records. HIPAA eliminated unnecessary, cumbersome procedures, saved the healthcare industry money, reduced medical errors, increased patient confidence, and improved the quality of care.