What’s A HIPAA?

By: AnnaMarie Mock, CFP® 

HIPAA stands for Health Insurance Portability and Accountability Act and was enacted by Congress in 1996. The original purpose of HIPAA was to simplify and unite a fragmented health care system, enabling health information to be electronically shared between providers and prevent healthcare fraud.  

Since then, HIPAA has been updated several times adding additional provisions through the years. The HIPAA Privacy Rule of 2003 is one of the most notable updates. It defined ‘Protected Health Information’ (PHI), and patients were given the right to obtain copies of their PHI. The Privacy Rule took effect on April 14, 2004. 

The regulations prohibit health care providers from disclosing PHI, which includes an individual’s past, present, or future physical or mental health condition to anyone other than the individual. Health care providers may not disclose the PHI except for purposes of carrying out treatment or payment, or unless authorized by the individual in writing in the absence of a medical release or designation of health care agent that complies with HIPAA.   

In order for the authorized health care agent to be the recipient of the individual’s medical information, as determined by the Privacy Rule regulation, the authorization to release information must meet the following criteria: 

  1. Written document signed and dated by the individual 

  2. Include the HIPAA disclosure information 

  3. Identify an agent to speak on your behalf 

The appointed agent has the same power as the individual themselves. The agent is authorized to approve health care services, have access to medical records, and consent to their disclosure on behalf of the individual. 

How do you appoint an agent to speak on your behalf?  

To ensure that a health care agent can readily access medical records, you should execute a Medical Power of Attorney that specifically incorporates the HIPAA release provisions and identify the agent as the personal representative.  Coupled with the Medical Power of Attorney, you should, also, get a Health Care Medical Directive to identify what your wishes are if you were to become incapacitated.  

There may be some additional changes to HIPAA in 2019 to reduce the administrative burden on HIPAA covered entities which includes health plans and health care providers that transmit PHI under the Department of Health and Human Services standards. Their goal is to not make material changes to the protection of patient privacy or decrease security of PHI, but instead aim to provide rights to an individual to access copies of their PHI and specify the timeframe to respond, provide encouragement of information sharing for coordination of treatment, and address the opioid crisis. 

If you have any questions related to HIPAA or your personal estate documents, please do not hesitate to reach out to the Highland team.