Definitions for "Health Insurance Portability and Accountability Act of 1996"
The Act was enacted to make health insurance more "portable" from one employer to another. The law mandates procedures for both new hires and for existing employees who are leaving the company. Employees who are new to a company can use evidence of previous health care coverage that is provided by their former employer to reduce or eliminate the new employer's preexisting condition requirements. Employees who are leaving a company must be provided a certificate of prior creditable health care coverage to use for this purpose. The law includes other provisions regarding restrictions on preexisting conditions, special enrollment rights and privacy rights and protections.
The health insurance reform law known as HIPAA established a coordination of health care fraud and abuse activities known as the Fraud and Abuse Control Program and the Medicare Integrity Program. The law requires the government to issue written advisory opinions in order to assist providers in understanding the requirements of the fraud and abuse laws, which are frequently criticized as vague and overly broad. The act also expands coverage of the fraud and abuse laws beyond the Medicare and Medicaid programs to include not only all federal health plans but also certain offenses to private health plans as well. The insurance portability part of the act addresses the problem of retaining the same health insurance coverage as workers move from job to job. Back to the top of the page
A Federal law that allows persons to qualify immediately for comparable health insurance coverage when they change their employment relationships. Title II, Subtitle F, of HIPAA gives the Centers for Medicare and Medicaid Services the authority to mandate the use of standards for the electronic exchange of health care data; to specify what medical and administrative code sets should be used within those standards; to require the use of national identification systems for health care patients, providers, payers (or plans), and employers (or sponsors); and to specify the types of measures required to protect the security and privacy of personally identifiable health care information. Also known as the Kennedy-Kassebaum Bill, the Kassebaum-Kennedy Bill, K2, or Public Law 104-191.