The Health Insurance Portability and Accountability Act of 1996 was enacted by the American Congress and signed by President Clinton in 1996. It has been named after two prior legislations that intended to cover workers and their families whenever they lose their jobs. It is organized in terms of titles that define its scope and breadth to certain individuals who adhere to specific insurance policies since it amends income security acts, internal revenue codes, and public health service acts as they exist. As per the legislative provisions, the title further limits restrictions that health plans can place benefits where group plans may be rejected; for instance when subscription does not conform to specific timelines.

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In addition, the policy provides methods for calculating continuous coverage among individuals depending on their agreed health plans. Although the limited coverage plans are sometimes exempt from the legislative requirements, it allows people to apply for coverage during exclusion. On the other hand, it defines policies, guidelines, and procedures for maintaining security and privacy of individually identifiable health information to avoid the emergence of criminal penalties due to unintended violations. Further, the legislation has been used to set standards that aim at increasing efficiency of the healthcare system in terms of collection, management, application, and dissemination of healthcare information (104th Congress, 1996).

The featured legislation was intended to make healthcare infrastructure more efficient through standardization of transactions, their simplification, and engagement of all health plan providers through standardized ways. From the administrative perspective, enforcement of the policy legislation is done by the department of human resources. This agency became effective as of the year 2006 where it established procedures related to investigations and hearings of violations. Before then, few violations had been prosecuted, and there lacked standardization that made the whole information sharing process inefficient while generating unintended consequences within healthcare organizations.

As per the enforcement body, protection of health information, access to information, safeguards to electronic information, and the establishment of operating standards are of importance, especially when dealing with insurance groups, small providers, hospital chains, and other institutions specializing in healthcare services. As of the year 2013, the department of human resources has had numerous cases resolved, and the most important thing is the implementation of corrective measures whose intention is to improve current health care plans and their provisions. In relation to security act, this legislation is intended to amend security acts, income security acts, and revenue codes that govern the provision of healthcare services.

Before implementation of the legislation, there were issues related to violations occurring during the provision of healthcare services. There existed no rules to govern the dissemination of patient information and providers found themselves issuing data to other entities without considering the subsequent implications. Although some instances have seen physicians refuse to disclose patient information even to authorized parties, it has been found that accurate information is being disseminated through standardized protocols. Sometimes, the documents are being perceived as complex and legalistic, but the outcomes of the whole legislative process are increased care provision and standard information sharing processes.

In light of the mentioned critical issue, a security rule was issued in the year 2003, and full compliance was experienced in the year 2005. As per this policy, providers were supposed to use the security rule to complement privacy rules pertaining to protected information whether in paper or electronic form. Three types of safeguards, administrative, technical, and physical, have been applied to ensure that required specifications are adopted and administered as per the rule. It means that every provider in America is supposed to adhere to the rules flexibly in accordance with the standards. Particular, administrative safeguards illustrate specific ways for compliance as per the unique needs of entities.

From an administrative standpoint, Walshe & Smith (2013) have provided some justifications relevant for securing information requirements in the quest to improve healthcare efficiency. Based on these provisions, the overall stance to the issue of compliance and corrective mechanisms is that the law is serving its role and should be applied in every healthcare sector. Technical, physical, and administrative requirements are important and the governing agencies are supposed to increase their efficacy to ensure that every entity does not violate any security provisions, and if it occurs, then the relevant punitive measures must be implemented.

Despite support for the legislation and its remediation of the core issue, it has some drawbacks that must be considered for optimal outcomes. One of the drawbacks is that some physicians and institutions are refusing to share information with authorities due to the notion that they may be punished. On the other hand, there exist some inefficiencies in terms of information collection since some people are noting that disclosure forms are lengthy, complex, and contain intricate legalities. On the upside, the policy is beneficial in terms of ensuring that providers have standardized ways to share and use information to improve the quality of services as per legislative requirements.

Research indicates that the legislation has varied implications on the healthcare industry especially in the process of implementation and compliance. The costs of implementation are increasingly becoming higher for those reluctant to comply at different administrative levels. However, institutions can benefit from the legislature if they implement the requisite training and education programs since they are paramount to the enlightenment of regulatory backgrounds, as well as the correct implementation of the privacy and security acts. Therefore, the only option is to adhere to the policies at their minimums for optimal generation of intended outcomes.

  • 104th Congress. (1996). Health Insurance Portability And Accountability Act Of 1996. Washington, DC: Congress.
  • Walshe, K., & Smith, J. (2013). Healthcare Management. Boston, MA: Open University Press.