Fifteen years after HIPPA passage
Some provisions still a work in progress
Fifteen years ago, the Health Insurance Portability and Accountability Act breezed through Congress and, on Aug. 21, 1996, President Bill Clinton signed it into law. The law remains vital, despite its age, with several key HIPAA compliance deadlines looming. They include Jan. 1, 2012, for use of the ASC X12 Version 5010 data transmission standards, as well as two standards for retail pharmacies and Medicaid pharmacy subrogation, and Oct. 1, 2013, for use of ICD-10 diagnosis and procedure codes.
The once popular and subsequently oftbemoaned law has its share of measured defenders.
“It all depends on your definition of success,” said Robert Tennant, senior policy adviser for the Medical Group Management Association.
The aim of one major section of HIPAA, “administrative simplification,” was to control rising healthcare costs through computerization and data standardization. “By stimulating the industry to move more toward standardization and thinking more about standardization, it was very successful,” Tennant said, but, “Did it succeed in driving out costs? No.”
Introduced in the Senate by co-sponsors Sens. Edward Kennedy (D-Mass.) and Nancy Kassebaum (R-Kan.), the wildly popular bill passed by votes of 98-0 in the Senate and 4212 in the House. It targeted a then-widespread payer practice of excluding coverage to people for their pre-existing medical conditions. Group plans offered to small employers as well as individual health plans were exempt, however. Thus, it will be left to the Patient Protection and Affordable Care Act of 2010 to eliminate exclusions for pre-existing conditions entirely, and not until 2014, 18 years after HIPAA became law.
“From an insurance perspective, I think it’s had a significant impact, because it did change the way we looked at health insurance and made it transferable,” said Dan Rode, vice president for advocacy and policy at the American Health Information Management Association. People with medical conditions were no longer locked into a job over fear of losing healthcare coverage. “I think it realized a lot of benefit from that standpoint.”
And while administrative simplification remains a work in progress, Rode said, “I think we’re finally recognizing the importance of data in healthcare, and that’s exciting. And that’s certainly what HIPAA was supposed to do. I think in another 15 years or so, we’ll really have something to pat ourselves on the back about.”
Lawrence Hughes, assistant general counsel for the American Hospital Association and its expert on HIPAA privacy and security, noted that the law created a first set of nationwide standards in that arena and that the AHA and its members “support a lot of things that have occurred with privacy and security with regards