Define: Health Insurance Portability And Accountability Act

HIPAA is a federal law enacted in 1996 that aims to protect the privacy and security of individuals’ health information. It establishes standards for the electronic exchange of health information and sets guidelines for healthcare providers, health plans, and other entities that handle protected health information (PHI).

HIPAA applies to covered entities, which include healthcare providers, health plans, and healthcare clearinghouses. It also applies to business associates, such as third-party vendors or contractors, who handle PHI on behalf of covered entities.

PHI includes any individually identifiable health information that is created, received, or maintained by a covered entity. This can include medical records, billing information, health insurance information, and any other information that relates to an individual’s past, present, or future health condition.

HIPAA grants individuals several rights, including the right to access and obtain copies of their own health information, the right to request corrections to their health records, and the right to request restrictions on the use or disclosure of their PHI.

Under HIPAA, healthcare providers are generally required to obtain written consent from patients before disclosing their PHI to third parties. However, there are exceptions to this rule, such as for treatment purposes, payment transactions, or when required by law.

HIPAA violations can result in both civil and criminal penalties. Civil penalties can range from $100 to $50,000 per violation, depending on the level of negligence. Criminal penalties can lead to fines up to $250,000 and imprisonment for up to 10 years, particularly for intentional or malicious violations.

Employers are generally not allowed to access employees’ health information under HIPAA. However, they may have access to certain limited information for purposes such as administering employee benefits or complying with workplace safety laws.

HIPAA does not provide individuals with a private right of action to sue for violations. However, individuals can file complaints with the Department of Health and Human Services (HHS), which has the authority to investigate and impose penalties on covered entities that violate HIPAA.

HIPAA does not specify a specific retention period for PHI. However, covered entities are generally required to retain PHI for at least six years from the date of its creation or the date it was last in effect, whichever is later.

HIPAA includes several exceptions to its privacy rules, such as for law enforcement purposes, public health activities, research studies, and certain disclosures to family members or close friends involved in an individual’s care. These exceptions are designed to balance privacy protections with the needs of public health and safety.