Hipaa and The Employer

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A final HIPAA provision is important from a human resources stand point. "Employer Questions and Answers About HIPAA," has noted that the Act does not allow a plan or issuer to refuse to cover an employee because of his/her health status. But it does not prevent the employer from designing the health plan in such as way as to either establish limits on coverage for all employees with a similar condition or requiring a higher premium or contribution from all employees with the condition in question. This is an important distinction. Members of the covered group cannot be denied insurance, but the insurance may be tailored in such a way as to not cover certain treatments. However, such a tailoring must include all individuals within the group who might have need of such treatment.

HIPAA Requirements

HIPAA requirements are fairly complex and it would behoove Human Resources departments to do whatever is necessary to make sure that their staffs are knowledgeable about both the requirements imposed by the legislation and the benefits that flow from it.

Although HIPAA is a complex piece of legislation rife with a number of clauses, caveats and codicils, there are three core objectives that can be identified in the various sections of the law.

These include:

1. The development and implementation of exacting security measures, designed to achieve the highest degree of patient confidentiality possible;
2. The establishment of a standardized administrative system in which each separate health care facility, employer, patient, and insurance plan is designated by a uniquely encoded identifier;
3. Overall standardization of the handling of administrative and health data among involved parties, including health care facilities and insurance companies.
   

Clearly, the conditions set forth in the HIPAA legislation will necessitate massive, sweeping changes in the American health care industry. In the past, each individual health care facility has maintained its records in a way that was best suited to the unique purpose of the particular organization or office.

As a result, there exists little or no standardization between health care facilities and organizations in the bulk of patient records. The amount of time and financial resources that will be necessary to design and implement a standardization and security system that can be used at every level of the American health care industry will no doubt be staggering.

HIPAA Benefits

While there are some administrative costs associated with HIPAA its benefits are enormous, particularly for small employers, because it makes it much easier to obtain coverage than had been the case before the Act entering into effect. Since HIPAA legislation was first proposed, the reactions in the published literature on the subject have varied widely. It is only in the last several years, as the implementation deadline for HIPAA grew nearer, that more extended, careful analyses of the ramifications of HIPAA have appeared in the literature with regularity. This preliminary review of recent literature on the subject will trace the trajectory of the analytical approach to HIPAA through a discussion of five representative articles.