Here’s An Opinion On:
Submitted by: Greg Garner
The Health Insurance Portability and Accountability Act (HIPAA) contains a number of laws to ensure suitable insurance cover for an individual as well as the privacy and security of the protected health information (PHI). But besides understanding the fields covered by HIPAA it is equally important to know what is not covered by this law.
To begin with, HIPAA allows sharing of PHI for consultation and management of your treatment or payments for services and premium. Also such data can be shared with government and law enforcement agencies if there is any perceived threat to the public or even to you. Providing de-identified data for research purposes is another example where the disclosure of such data is permitted.
The 4 points mentioned below will tell you the aspects that are not covered by HIPAA regulations.
Entities: HIPAA laws have to be followed by covered entities only, which include health care providers, health plan and clearing houses. However there are several other agencies that have your medical data but are not covered entities and thus do not have to follow the specific rules. Some such entities are workers compensation, life insurance companies, social security agencies, health benefit that are a part of automobile insurance, employment records, any health related information provided by you during surveys, correctional facilities, and bodies that collect data like cholesterol and blood pressure from pharmacies or public places like fairs and shopping malls.
Facilities: There are certain long-term insurance as well as vision and dental plans that are not covered by HIPAA unless of course they are a part of your employer s health plan. However you must know that the law does not require the employer to provide any health cover at all. Furthermore the plan provided by the employer need not cover any particular health condition that you may have.
Conditions: HIPAA has laid down certain restrictions on pre-existing conditions so that insurance cover is neither denied to an individual nor is there is any kind of discrimination. However any treatment that you have received during the last six months is not covered by HIPAA and allows the employer to impose certain pre-existing conditions for that period.
Security vs. Privacy: When reading the HIPAA rules it is important to note that the Privacy Rules provide a comprehensive protection to all your personal information across all media irrespective of being on paper or in electronic medium, and even those communicated verbally. Whereas the Security Rules of HIPAA apply only to the data in the electronic format and covers information stored on computers or digital storage as well as data transmitted through the internet. Any breach caused in storage and transmission of data available on paper is not covered by the Security Rules.
However certain entities and situations detailed above may be governed by other state laws or industry standards which may require them to follow prescribed guidelines to keep your personal information confidential and secure. You on your part must be extra careful when divulging sensitive information especially in the absence of HIPAA protection.
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