| One element of health
care that HIPAA regulates is health information. HIPAA
defines health information as information that is "oral
or recorded in any form or medium," and created
or received by a healthcare provider, health plan, or
public health authority. HIPAA elaborates on this definition
by noting that this information can relate to the "past,
present, or future physical or mental health or condition
of an individual, the provision of health care to an
individual ... [or] payment for the provision of health
care to an individual."
Since obtaining personal healthcare information is
an essential part of running a health plan, HIPAA applies
in many situations that plan administrators face. Transmission
of personal health data is necessary because health
plans work with billing for procedures, claims, and
enrollments among patients. Although HIPAA specifies
the protective measures that an individual transmitting
personal health data must follow, including consent
for use or disclosure of information, HIPAA does not
require authorization for transfers that pertain to
payment, claims, eligibility for a health plan, or enrollment
in a health plan. Due to this leniency, many states
have enacted stricter privacy laws.
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Creating stringent privacy laws is an effective method
for legislators to protect their consumers, as state
law trumps HIPAA when the state law is stricter. However,
in order to meet the "more stringent" criterion,
the law must relate to protection of "individually
identifiable health information." A law ""relates
to the privacy of individually identifiable health information'
when "the state law has the specific purpose of
protecting the privacy of health information or affects
the privacy of health information in a direct, clear
and substantial way."' Conflicts typically arise
as states often prohibit the use or sharing of health
information in situations where HIPAA allows the release
of this data. Furthermore, states often increase the
privacy rights of an individual in relation to private
health information. As such, health plan administrators
must be aware of both federal and state privacy regulations.
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Health Insurance
The computerization of medical records and the increased
reliance upon computers, telecommunications, and other
technologies has caused patients, health care providers,
and many other participants in the provision of health
care to focus on patient privacy and medical record
confidentiality. A question arises as to whether the
new technologies increase or decrease the exposure to
misuse or disclosure of information that many consider
to be their most - or one of their most - important
secrets. The debate will continue as society adapts
to these new modes of processing information and people
better understand the capabilities (good or bad) of
the technology. Currently, professional organizations
and private interest groups are lobbying for the enactment
of laws that address this concern.
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