HIPAA
Are you compliant?

The Health Insurance Portability and Accountability Act of 1996:

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was signed into law on August 21, 1996. This law includes important new protections for millions of working Americans and their families who have preexisting medical conditions or might suffer discrimination in health coverage based on a factor that relates to an individual's health. HIPAA's provisions amend Title I of the Employee Retirement Income Security Act of 1974 (ERISA) as well as the Internal Revenue Code and the Public Health Service Act and place requirements on employer-sponsored group health plans, insurance companies, and health maintenance organizations (HMOs). HIPAA includes changes that:

• limit exclusions for preexisting conditions;
  
• prohibit discrimination against employees and dependents based on their health status;
  
• guarantee renewability and availability of health coverage to certain employers and individuals;
  
• protect many workers who lose health coverage by providing better access to individual health insurance coverage.

Preexisting Condition Exclusions:

Under HIPAA, a group health plan or a health insurance issuer offering group health insurance coverage may impose a preexisting condition exclusion with respect to a participant or beneficiary only if the following requirements are satisfied:

• a preexisting condition exclusion must relate to a condition for which medical advice, diagnosis, care or treatment was recommended or received during the 6-month period prior to an individual's enrollment date;
• a preexisting condition exclusion may not last for more than 12 months (18 months for late enrollees) after an individual's enrollment date; and
• this 12- (or 18-) month period must be reduced by the number of days of the individual's prior creditable coverage, excluding coverage before any break in coverage of 63 days or more.

How will the new law help:

If you need more information about HIPAA, you may visit Hep-c Alert Website.