I've been paying careful attention to the health care debate, because I'm self-employed. Among other things, that means I buy my own health insurance policy. My current plan has some shortcomings, so I'm hoping that I'll eventually have a few more options when it comes to health insurance policies.
The last time I applied for a new insurance policy, I didn't read all of the fine print on the application form. I was surprised, a few weeks later, when the insurance company called me with some questions.
The application form I completed had asked me to list all prescription drugs I'd taken over the last five years. Now, I don't know about you, but I've had some run-of-the-mill health problems over the years, so I listed all of the drugs I remember taking. It turns out that when I'd signed the application form, I'd given the insurance company permission to access my health records, including my prescription drugs records. They called me to ask about some of the things I'd accidentally left off of the list, like the antibiotic my doctor recommended I carry with me in case I got sick on a trip to Africa. And the pain killer I'd used after minor out-patient surgery.
I was surprised that I'd forgotten ever having received these drugs, but I was more surprised that there was a list in some database that itemized every prescription drug I'd ever taken. The experience gave me a crash course in medical privacy, but I also learned that there is a lot of medical information being collected about every one of us that we may not even realize exists.
The Health Insurance Portability and Accountability Act, commonly known as HIPAA, gives each one of us the right to keep our health information private. HIPAA, along with some state laws, affect how our health information can be used or shared.
What Are Your Rights?Health care providers and health insurers who are required to follow HIPAA must comply with your right to:
- Ask to see and get a copy of your health records
- Have errors in your health records corrected
- Receive a notice that explains how your health information can be used or shared
- Decide if you want to allow your health information to be used or shared
- Get a report on when and why your health information was shared
- File a complaint with your provider or with the U.S. Department of Health Human Services if you think your rights have been violated or your health information isn't being protected
While you must give your written permission before your health information is used by or shared with your employer, mental health counselors or for marketing purposes, the information can be used and shared without your permission:
- If it is necessary for your treatment and the coordination of care
- If it is related to medical bills for your care and treatment
- With family members and friends you've previously identified who are involved in your health care or managing your health care bills
- If it is necessary to ensure that you are provided good care by doctors, and a clean and safe environment in nursing homes
- If it is necessary to protect the public health by reporting flu and virus incidents in your area
- If medical professionals are required to report injuries such as gunshot wounds to law enforcement
What Information Is Protected?HIPAA requires the following health and medical information be protected from unauthorized use or sharing:
- Information placed in your medical records by health care professionals
- Conversations your doctor has with other health care professionals about your care and treatment
- Information about you that is stored in your health insurer's data systems
- Billing information about you
- Any other health information that is kept by those who must comply with HIPAA
Who Must Comply with HIPAA?A number of people and entities are required to protect your health information and comply with HIPAA. These include:
- Doctors, nurses, pharmacies, hospitals, medical clinics, nursing homes and other health care providers
- Health insuring organizations including insurance companies, health maintenance organizations (HMOs), independent physician associations and provider networks
- Medicare, Medicaid and other state and federal government programs that pay for health care
HIPAA can be a tricky law. For example, I wasn't happy to learn that, as part of my application for health insurance, the insurance company could pull all of my old medical records. Then I went back to read the fine print on the application I'd signed. It said that if I refused to release my medical records, they would automatically decline my application. In my case, I had to decide which was more valuable to me: my medical privacy or health insurance. If you're faced with a medical privacy issue, it's vital to know your rights under HIPAA.
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