The Health Insurance Portability and Accountability Act (HIPAA) ensures that individuals have access to health insurance, even when there’s a significant time lapse between an old plan and a new plan, such as when there’s a job loss. It was also created to protect the privacy of patients as it pertains to their electronic health records. It is a federal act passed by Congress that all health care professionals and companies must abide by, if they ever have or want to deliver medical services to you.  While on its face HIPAA privacy rules appear to benefit patients, there are 5 disadvantages to be aware of:

Disadvantage #1 - No Standing to Sue

Even though your privacy rights may be violated, you don’t have standing to sue companies because of their HIPAA violations. The United States Department of Health and Human Services is charged with enforcing the provisions under HIPAA and you would have to file a complaint with them.

Disadvantage #2 - Shortcomings in Enforcement

Private individuals have complained about HIPAA violations since it was enacted.  There’s a public perception that the United States Department of Health and Human Services does not actually enforce the act against institutions and professionals who violate HIPAA privacy rules. As a result, some patients lack confidence that HIPAA does anything, due to its shortcomings in enforcement.

Disadvantage #3 - Extra Staff Required

Companies may have to hire extra staff to keep up with HIPAA requirements.  Larger-sized companies need dedicated staff to work on the privacy of their patients. That results in extra costs that are eventually passed on to patients, and leads to an increase of their medical bills.

Disadvantage #4 - Consent Not Required for Payment

HIPPA privacy rules does not mandate that a hospital, doctor’s office or agency obtain your consent prior to submitting a claim to your insurance company. For example, if you show up for treatment to your doctor’s office and they have your health insurance information, they can immediately submit a claim for pay without asking your permission first. That takes away your option of self-pay, or more importantly, your decision to decide what claims you want submitted to your insurance company.

Disadvantage #5 - Information Shared with Outsiders

Companies often contract with other providers for services, such as billing and legal services. These contractors have access to patient records as part of doing their job. You don’t have a choice about that, and your consent is not required under HIPAA rules. Companies do use written agreements with contractors to obtain their agreement to keep the information they receive confidential, but if there is a violation, you don’t have the ability or standing to sue. You’re left to hope that your complaint will be taken seriously enough to result in legal enforcement actions.

Be informed as much as possible about your rights under HIPAA privacy rules, so that you’re not surprised about how your information is shared. You can also take steps to protect yourself, such as amend medical records if appropriate.

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