Health insurance portability and privacy — Iowa

The Health Insurance Portability and Accountability Act (HIPAA) has a significant impact on the medical coverage provided by employer-sponsored group health plans. While an employer itself will generally not be subject to HIPAA and its corresponding requirements, it is nevertheless still important for organizations to recognize the general duties under the act should they ever come into possession of protected health information (PHI).

• requires a group health plan to limit exclusions based upon pre-existing conditions

• prohibits such plans from denying coverage to individuals or charging higher premiums based on health status, medical history or certain other factors

• guarantees renewability of coverage to certain individuals

• requires a group health plan to provide for the privacy and security of plan participants’ protected health information.

Covered entities (i.e., health plans) and/or business associates who violate HIPAA’s portability, privacy or security provisions may face fines and/or lawsuits for failing to meet these requirements.For purposes of HIPAA’s requirements, health insurance coverage means benefits for medical care under any hospital or medical service policy or certificate, hospital or medical service plan contract, or HMO contract offered by a...

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