HIPAA
The Health Insurance Portability and Accountability Act (HIPAA) was passed by Congress in 1996. It took five years for it to become effective (April 14, 2001), and another two years before compliance was mandatory (April 14, 2003).
The original intent of the law was two-fold: portability and accountability. The portability functions to protect individuals from losing their insurance coverage when leaving or changing jobs and to prevent employers from imposing pre-existing condition clauses. The accountability portion provides the federal government with increased power with regards to fraud and abuse issues in health care.
Another impetus for HIPAA legislation was the need to create electronic health records (EHR) and management systems that would require layers of security, but would get medical records out of massive storage areas and into an arena where they can be readily accessed to provide better and safer care for patients.
Of course, implementation has been costly and will continue to be costly for a while. HIPAA is an evolving process and a huge example of how legislation has to see far into the future to predict and account for possible changes. At the time this law was passed in 1996, the Internet and electronic information processes were basically in their early toddler stages. As technology advances, new and more complex implications have to be considered.
Prior to September 11, 2001, terrorism, bioterrorism, and threats of identity theft had very different meanings. Today, all those issues play a big part in protecting the privacy and confidentiality of health care records. The issue of accessing medical records for homeland security situations is also a factor that was basically nonexistent at the time HIPAA was legislated.
Nurses need to be kept up-to-date with all issues related to HIPAA and patient confidentiality and privacy concerns. This is an evolving process; not one you learn once and move on. Patients need to understand their rights and to participate in their health care. Nurses need to educate patients and therefore need to keep up-to-date with changes.
A lot of misinformation about HIPAA and its implementation has been abundant in the health care arena. Some misinformation derived from the fear of penalties and allowed rumors to abound. HIPAA “experts” emerged from every nook and cranny to provide seminars and publish materials in multiple formats that are available at exorbitant prices. Many fortunes have been made by less than reputable sources, which have made it more difficult for the truth to be spread by those who really understand the rules.
