MEDICAL INSURANCE

Medical Insurance

Medical Insurance

Introduction

Rothstein (2005) noted that the passage of the HIPAA regulations has caused much confusion among the health care community; he blamed some of this confusion on the lack of resources and the lack of education that needed to be directed to those who would be involved in the implementation of the new rules. Rothstein explained some of the misconceptions regarding the Privacy Rule and to whom the rule applies. He stated, based on its intent to regulate financial transactions in health care, the Privacy Rule applies only to three classes of covered entities - health care providers, health plans, and health clearinghouses. The Privacy Rule does not apply to employers, insurers, schools, or other entities that may have health information, except to the extent that they perform functions of a covered entity, such as providing and billing for health services. Rothstein further explained that HIPAA controls protected health information (PHI) which is “… defined as individually identifiable health information” (Rothstein, 2005, 4). In addition, Rothstein emphasized that HIPAA provides individuals with the right to access their medical records, the right to ask for an amendment to their health records, and the right to a clarification of the disclosure of their health records.

Discussion

Rothstein (2005) expounded on the areas in which the Privacy Rule and the Common Rule differ. Starting with the purposes and the oversight divisions, Rothstein indicated that the Privacy Rule is concerned with the safeguarding of the privacy of individuals and the disclosure of PHI by those entities covered by the act; he noted that alleged violations are handled by the DHHS Office for Civil Rights. The Common Rule's purposes are the safeguarding of human welfare during research, and the privacy and confidentiality of their information; the alleged violations of this rule are investigated and handled by ...