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Author: Jayne Zanglein, Western Carolina University
The Health Insurance Portability and Accountability Act of 1996 (HIPAA):
- Protects health insurance coverage for employees and their dependents that lose coverage or change jobs. See Portability of Health Care Coverage.
- Limits exclusions of coverage for pre-existing medical conditions for up to 12 months for initial enrollment periods and for up to 18 months for late enrollment periods. See Pre-Existing Condition Exclusions.
- Was strengthened by the Patient Protection and Affordable Care Act (PPACA). See Pre-Existing Condition Exclusions.
- Provides employees with access to high risk insurance coverage pools after coverage, including coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA), terminates under the plan. See Eligibility for High Risk Pools Upon Termination of Coverage.
- Prohibits discrimination against workers for pre-existing conditions and genetic information. See Nondiscrimination Rules.
- Phases out annual and lifetime dollar limits on essential health benefits. See Benefits and Benefit Plan Changes; Future Developments.
- Establishes privacy rules designed to safeguard protected health information (PHI). See Medical Privacy Under HIPAA.
- Establishes security rules designed to safeguard electronic PHI (ePHI). See HIPAA's Security Rule.
The following states have additional requirements for this topic under applicable state law.
- District of Columbia
- New Hampshire
- New Jersey
- New Mexico
- North Dakota
- Rhode Island
- South Carolina
- South Dakota
- West Virginia