HIPAA Flashcards

1
Q

What does HIPAA stand for

A

Health Insurance Portability & Accountability Act

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2
Q

HIPAA objectives

A

Enables American workers and their families to transfer and continue their health insurance coverage when they change or lose their jobs.

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3
Q

HIPAA privacy rule

A
  • Provides federal protection for an individual’s health information
  • Gives patients rights regarding individually identifiable health information
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4
Q

HIPAA Security Rule

A

Provides technical safeguards to assure the confidentiality, integrity, and availability of electronic protected health information

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5
Q

HIPAA Requirements

A
  • Employers with >=20 employees to allow former employees to continue benefits under the employer’s health insurance
  • Healthcare providers must follow HIPAA requirements when disclosing protected health information
  • A policyholder must be given notice of information practices at least every 3 years
  • When an employee begins a new employment immediately after leaving the previous employer, he/she is eligible for group health insurance coverage upon hire.
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6
Q

HIPAA Requirements (Continued)

A
  • A group health policy renewable can be denied if an employer violated the participaton or contribution rules
  • The 10% exercise tax for early withdrawal from an IRA will not apply if the withdrawal is used to cover medical expenses 10% above an individual’s adjusted gross income as of 2019.
  • HIPAA limits the ability of a new employer plan to exclude coverage for pre-existing conditions
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7
Q

HIPAA Application

A
  • to all group health insurance plans, except
  • disability income plans
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8
Q

HIPAA Pre-existing Conditions - Definition

A

Health issues that existed, were treated, or diagnosed within 6 months prior to employment.

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9
Q

HIPAA Pre-existing Conditions - Portability

A
  • Transferring from one health plan to another.
  • This usually happens due to job change or your employer switching to a new insurance company
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10
Q

HIPAA Pre-existing Conditions - Portability Rules

A

Allow individuals who change from one group medical plan to another to reduce or eliminate any pre-existing conditions excluded under the new plan. So, this individual is eligible for coverage upon hire.

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11
Q

Creditable coverage

A

Creditable coverage is health insurance, prescription drug, or other health benefit plan that meets a minimum set of qualifications.

Types of creditable coverage plans include group health plans, individual health plans, student health plans, as well as a variety of government-sponsored or government-provided plans.

Creditable coverage is used to determine coverage and costs associated with pre-existing conditions, and whether policyholders have to pay late enrollment penalties

The Medicare Modernization Act imposes a late enrollment penalty on individuals who do not maintain creditable coverage for a period of 63 days or longer following their initial enrollment period for the Medicare prescription drug benefit.

The 63-day period starts when one’s previous coverage ends, and ends when his/her plan/waiting period of the plan starts.

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12
Q
A
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