Health Insurance Portability and Accountability Act [HIPAA]

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The abbreviation HIPAA is of Health Insurance Portability and Accountability Act. It was enacted by US Congress a law in 1996, to regulate Healthcare Insurance Industry across USA. The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule is the first comprehensive Federal Protection Act for the privacy of personal health information. The research organizations and its associated researchers may or may not be covered under the HIPAA Privacy Rule. It is a group of rules and regulations for combating waste, fraud and abuse in health insurance, and healthcare delivery. HIPAA has been enacted to improve the effectiveness and efficiency of the healthcare systems, portability and continuity of health insurance coverage in individual and group markets, and the ability to facilitate consequences to those evaders who do not comply with the regulations explicitly as stated within the Act.


The HIPAA provides protection pertaining to health insurance coverage for employees and their families, especially when such employees change or lose their jobs. It promotes the usage of medical savings accounts, improving access to long-term care services and its coverage as well as simplification of the administration of healthcare insurance. As a federal law, the scope for pre-existing disease exclusions is minimized, permitting special enrollment when certain unexpected life incidents occur in an individualís life. Prohibition of discrimination against employees and their dependents based on their current health status, thereby ensuring the availability and renewability of health insurance coverage to employees and individuals under general circumstances and facilitation of the portability for group coverage from one carrier to another group carrier is ensured under this act.

The HIPAA regulations ensure guaranteed issue and renewal of insurance coverage, prohibiting insurance plans from charging the individuals, higher premiums, co-payments and/or deductibles based on their health status. Pre-existing terms and conditions may not be imposed if individual or group coverage was effective for 12 months (i.e. one year) and not more than 63 days has elapsed between coverage of the two policies. If health insurance coverage was less than 12 months then pre-existing clause may be imposed for only that portion of the 12 months that were not covered. The Health Insurance Portability and Accountability Act (HIPAA) makes it binding and mandatory that a maximum of 12 months may be imposed for covering a pre-existing disease, which means that individuals would not be penalized for undergoing medical treatment with respect to chronic and life-threatening illnesses that occurred in the past.

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