HIPAA Confidentiality Requirements

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The Health Insurance Portability and Accountability Act (HIPAA) pertains to individual and employer health plans. Some provisions in the Act place restrictions on employers, such as not basing health insurance premiums on health-related issues or penalizing employees for preexisting conditions. The Act guarantees continuation of health care coverage upon job termination. Also included in HIPAA is the right to privacy and confidentiality of employee medical information.

Health Care Information

Whenever you see a doctor, go to the hospital or visit a local clinic, personal information is required in order to be treated. Any information that is gathered and placed into your medical record is private under the HIPAA confidentiality requirements. Patients can, however, sign a consent for information to be disclosed to relatives, spouses, etc. if there are legal actions incurred or for the billing of medical insurance.

Conversations with Medical Personnel

Just as medical information and records are confidential, so are the conversations you have with medical personnel. Any discussion of a disease, symptoms, operations, medication or treatment is considered confidential information. Medical facilities will present HIPAA forms and waivers to be signed for permission to share information and with whom.

Marketing or Sales Promotions

HIPAA protects the medical records, history or treatment plan of any patient from being exploited for money or marketing purposes. In other words, confidential information cannot be released to pharmaceutical sales representatives or any experimental drug programs without direct written permission from the person.

Exceptions to the HIPAA Rule

There are certain things that HIPAA does not do, and most cases are considered on an individual basis. For example, HIPAA does not force employers to provide health care insurance if they do not typically offer that as a benefit. Also, if a former employee does not have health care insurance for a period of 63 days, there may be a waiting period for preexisting conditions that would not occur if the person had coverage.


About the Author

Based in Dallas, Texas, Marcia Moore has been writing business-related materials since 1974. She has enjoyed a 30-year career in the field of human resources and works as a HR consultant to small and medium businesses. Moore holds a Master of Science in social work from the University of Texas in Arlington.

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