The Health Insurance Portability and Accountability Act (HIPAA) caused far-reaching changes in healthcare insurance reform, electronic healthcare transactions, healthcare fraud and abuse regulations, and privacy protection for individually identifiable health information. While HIPAA may be best known for its medical record access and privacy provisions, HIPAA’s portability aspects and administrative simplification regulations are of particular relevance to employers.
HIPAA was designed, in part, to enhance health insurance portability for people when changing jobs or health plans and removes obstacles to adding family members to an employee’s coverage. For example, portability requirements under HIPAA prevent employers and insurers from denying coverage based on preexisting conditions. As discussed in Health insurance reform, under the Patient Protection and Affordable Care Act (ACA), preexisting conditions exclusions are prohibited for all group health plans and for non-grandfathered coverage obtained in the individual market for plan years beginning on or after January 1, 2014. As a result, the Internal Revenue Service (IRS), the U.S. Department of Labor (DOL) and the U.S. Department of Health and Human Services (HHS) revised the HIPAA portability regulations to reflect the ACA’s ban on preexisting condition exclusions. Therefore,...
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