subject: Hipaa Violations On Insurance Plans [print this page] The private American Health care system was the source of a number of injustices that went unregulated since its beginning. This changed in 1996 with the passing of the Health Insurance Portability and Accountability Act (HIPAA) 1996.
HIPPA allows access to all areas of healthcare including renewing and freedom to choose physicians. HIPPA also increases the accessibility of group insurance plans and encourages the exchange of data via electronic means. There are also allowances that help to reduce the abuse of privileged medical information to lower fraudulent activities. Other sections of the Act allow patients to access and make copies of their own medical records and be be given notice before their information is shared. Employees are now able to move freely from job to job without losing their medical coverage or experiencing long time of no health care coverage.
Insurance providers who were not in support of HIPPA voiced their dislike of the privacy requirements; stating that they would put financial burden on providers while they enacted in place to comply. The law initially caused tens of thousands of privacy rule violation complaints.
As the United States continue to look for ways to keep health care reasonable without completely changing the current private, profit driven insurance system, finding ways to cut the costs of health care are an apparent place to begin. Decreasing the costs of administrative procedures and record-keeping are the most likely targets. With HIPPA the push to move towards electronic records keeping will help medical institutions and insurance providers to cut their costs thus being able to better accept the regulations.
HIPAA Violations
Failure to abide by with Health Insurance Portability and Accountability Act can result in costly fines and penalties. These are determined by the extent of the violation and the resulting harm that was caused.
HIPAA Violation
Minimum individual and Annual Penalty
Maximum individual and Annual Penalty
Individual did not they were committing a violation
$100 /$25,000 for repeat violations
$50,000 per violation, / $1.5 million
Occurred due to reasonable cause and not by purposeful neglect
$1,000 /$100,000 for (recurring violations)
$50,000 / $1.5 million
Occurred due to intentional neglect but was corrected within theappointed time period
$10,000 / $250,000 (for recurring violations)
$50,000 / $1.5 million
HIPAA violation is due to intentional neglect and is not corrected
$50,000 / $1.5 million
$50,000 / $1.5 million
Ever since HIPPA was enacted the Office of Civil rights has settled over 9000 violations. The most common of these was the disclosure of private health information without the patients knowledge or consent.
Insurance organizations are found to be in breach of HIPPA if they exclude pre-existing conditions for more than 12 months. They are also guilty of a breach if the insured is charged a higher premium for coverage because of their medical history, disability or other condition; of if it reduces individual benefits or services and does not inform the insured within sixty days.
by: Barbara Baddox
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