HIPAA Turns 10
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) turned 10 years old on August 21, 2006, but it is unlikely that many employers took time to celebrate. The milestone does provide a good reminder to employers to review existing policies and practices and ensure they are complying with HIPAA.
HIPAA has five parts, two of which are most applicable to group health plans:
- Rules related to portability, special enrollment and nondiscrimination; and
- Administrative simplification, better known as rules related to privacy, electronic data interchange and security of Protected Health Information (PHI).
First, employers should be aware of the portability requirements. These include issuance of Certificates of Creditable Coverage at varying times and pre-existing condition exclusions and their requisite notices. Special enrollment rights arise when there is the loss of other coverage or the addition of a new dependent or spouse through marriage, birth, adoption or placement for adoption. In a case decided earlier this year, a carrier’s failure to understand HIPAA special enrollment rules cost $750,000 in claims. HIPAA also prohibits discrimination based on health status factors. As more employers offer wellness incentives, they should be aware of the special HIPAA nondiscrimination rules related to those programs.
Second, the privacy and security compliance deadlines for large group health plans (those with more than $5 million in annual receipts) and small group health plans ($5 million or less) have already passed. This means these plans should already be in compliance with rules on privacy (focusing on the use and disclosure of PHI) and security (focusing on administrative, physical and technical safeguards of electronic PHI). In addition, large plans should have reissued an updated Notice of Privacy Practices no later than April 14, 2006 (it must be issued at least once every three years). As a practical matter, many plans issue these notices annually during open enrollment or contained within their Summary Plan Descriptions.
Infinisource offers several services to assist employers with HIPAA compliance. We can issue HIPAA Certificates of Creditable Coverage for employers. We also offer HIPAA Solved, a privacy/security product that employers can use to develop compliant policies and procedures. For more information, please contact our Sales team at 800-779-6384 or SalesSupport@infinisource.net
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