Who Is Covered By HIPAA And Who Is Not Covered

The Health Insurance Portability and Accountability Act (HIPAA) that was passed in 1996 by the U.S congress covers health plans, health care providers and health care clearing houses. Your medical information would be available to those who are not covered by HIPAA. The primary objective of the act was to allow patients access to their personal medical records and also improve access to health plans and grants.

The Health Insurance Portability and Accountability Act has a "Privacy Rule" that must be complied with by health care providers and health plans, There are various categories that are specified by the Act and while some of these categories are covered by it there are others that are not covered by it. This will also ensure that only authorized persons will be able to access your medical records and their usage will also be restricted.

What Are 3 Different Categories That Are Covered By HIPAA?

1. Health care providers - These include doctors, dentists, hospitals, laboratories, pharmacists and staff involved in your treatment. All health information that is transmitted electronically is covered by Health Insurance Portability and Accountability Act. So any health care provider who is in the business of providing health care and provides the information electronically will be covered by the act.

2. Health plans - When the cost of medical care is paid by anyone, it gets covered under the Health Insurance Portability and Accountability Act. The medical care cost could be paid by health insurance companies, health maintenance companies and any group health plans that are provided by the employer. Any other company that pays for your medical care will also be covered under the act.

3. Health care clearing houses - There are many organizations that act as a medium between the health providers and the health plans and these will also be covered by Health Insurance Portability and Accountability Act.

Apart from these three categories, business associates are also covered under the act.

What Are The Categories That Are Not Covered By HIPAA?

1. There are various agencies that provide social security and welfare benefits to people all over U.S and they will not be covered under Health Insurance Portability and Accountability Act.

2. Life insurance companies.

3. Law enforcement agencies

4. If the data is directly obtained from health care providers by researchers, it will not be covered by the act.

5. Screenings are conducted at public places for checking various ailments like diabetics, blood pressure and cholesterol. Those who conduct such screenings at public places will also not be covered by the act.

6. Schools and other state agencies will also not be covered by Health Insurance Portability and Accountability Act

All these institutions are not covered by Health Insurance Portability and Accountability Act although the information can be obtained from institutions that are covered by it. Apart from this HIPAA will only cover any information after April 3, 2003. This is the date on which the "Privacy Rule" came into effect. So check above to find out if you are covered.

For more information, please visit our HIPAA website.