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In this era of COVID-19, misinformation and misunderstanding abound. A recent example: People citing HIPAA as an excuse for not having shared their vaccination status.
HIPAA – the Health Insurance Portability and Accountability Act – is a federal regulation that protects patient information from sharing without their consent by health care providers and those with whom they do business.
“No one else is really covered,” said Julie Rovner, Washington chief correspondent for Kaiser Health News and host of the “What the Health” podcast.
She spoke about HIPAA and how parts of it have always been misunderstood in an interview on WPR’s “Central Time” with Rob Ferrett.
This interview has been edited for brevity and clarity.
Rob Ferrett: Can you give us the basics of what HIPAA is and why it exists?
Julie Rovner: HIPAA is actually 25 this month. It was signed in August 1996. What HIPAA has really done is allow you to quit a job with insurance and get another job with insurance and not have a waiting period. a year. So initially it was really all about portability.
It was a bipartisan bill, but the Republicans decided they wanted to have a little more of it, so they implemented a big chunk of administrative simplification by trying to streamline the way medical records were digitized. They were just getting started with electronic medical records in the 1990s.
It lasted about a year. At the very end, Congress said that if we want all of this electronic medical information to flow, we need to make sure it’s protected, that people’s health information isn’t accidentally leaked. And that’s where we got the privacy part of HIPAA.
In fact, it was not in the law. What the law says is that Congress should pass another law to ensure the confidentiality of this medical information by 1999. If not, the administration will. And of course, Congress missed the deadline.
The Clinton administration set the rules for confidentiality, the incoming George W. Bush administration tinkered with them a bit, and it’s HIPAA that we have today. It actually entered into force in 2003.
RF: What kind of things have you seen where people talk and misinterpret what HIPAA is doing?
JR: We saw athletes (and politicians) respond to someone who asks them if they are vaccinated by saying, “You can’t ask that because of HIPAA.” Well, I am a journalist. Journalists are not covered by HIPAA. We can ask for anything we want. Patients have the right not to respond. There is nothing that requires you to answer this question.
But there is nothing in HIPAA that prevents anyone from asking for it, including employers.
Employers should be careful because there are other laws that employers could accidentally break, such as the Americans with Disabilities Act. But employers are certainly allowed to ask employees for their immunization status if it has a business reason. And obviously today, with a contagious disease running everywhere, that would be a commercial reason.
RF: How limited are the privacy protections currently in HIPAA?
JR: Basically what HIPAA is trying to do is say that people who have what is called protected health information, your personal health information, cannot disclose it except to other people authorized to have it. have and to anyone to whom you give permission.
HIPAA also has a part where you can actually access your own medical records, which was not a legal right before HIPAA.
But it’s limited to people who collect your health information and have a reason to share it with others.
RF: Would HIPAA cover a city posting statistics on COVID-19, for example by zip code or municipal block?
JR: No, this is not the case. And HIPAA doesn’t cover most schools and school districts.
It would not be a violation of HIPAA law, but it could be a violation of privacy. Some states have stricter laws than HIPAA.
Over the years and as a reporter I’ve seen this many times – people refusing to answer questions, citing HIPAA when HIPAA has nothing to do with why they don’t want to answer questions.
I have seen vets quote HIPAA when they talk about animal health. HIPAA does not cover animals; it only covers people.
And that does not cover anonymized information, which is information that is not linked to an individual person, for example, the number of COVID-19 cases in a given community.
RF: One thing that is not covered by HIPAA is the information that we ourselves disseminate to the world. For example, researching health conditions on the Internet. This information is a fair game for Googles and others around the world to aggregate and do with whatever they want, isn’t it?
JR: Yes it is. Google is not a health care provider and neither are you.
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