Health Insurance Portability and Accountability Act

Health Insurance Portability and Accountability Act of 1996

Other short titles	Kassebaum–Kennedy Act, Kennedy–Kassebaum Act
Long title	An Act To amend the Internal Revenue Code of 1986 to improve portability and continuity of health insurance coverage in the group and individual markets, to combat waste, fraud, and abuse in health insurance and health care delivery, to promote the use of medical savings accounts, to improve access to long-term care services and coverage, to simplify the administration of health insurance, and for other purposes.
Acronyms (colloquial)	HIPAA (pronounced /ˈhɪpə/, HIP-uh)
Enacted by	the 104th United States Congress
Citations
Public law	Pub.L. 104–191
Statutes at Large	110 Stat. 1936
Legislative history
Introduced in the House as H.R. 3103 by Bill Archer (R-TX) on March 18, 1996 Committee consideration by House Ways and Means Passed the House on March 28, 1996 (267–151) Passed the Senate on April 23, 1996 (100–0, in lieu of S. 1028) Reported by the joint conference committee on July 31, 1996; agreed to by the House on August 1, 1996 (421–2) and by the Senate on August 2, 1996 (98–0) Signed into law by President Bill Clinton on August 21, 1996

The Health Insurance Portability and Accountability Act of 1996 (HIPAA; Pub.L. 104–191, 110 Stat. 1936, enacted August 21, 1996) was enacted by the United States Congress and signed by President Bill Clinton in 1996. It has been known as the Kennedy–Kassebaum Act or Kassebaum–Kennedy Act after two of its leading sponsors. Title I of HIPAA protects health insurance coverage for workers and their families when they change or lose their jobs. Title II of HIPAA, known as the Administrative Simplification (AS) provisions, requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers.

Title I of HIPAA regulates the availability and breadth of group health plans and certain individual health insurance policies. It amended the Employee Retirement Income Security Act, the Public Health Service Act, and the Internal Revenue Code.

Title I requires the coverage of and also limits restrictions that a group health plan can place on benefits for preexisting conditions. Group health plans may refuse to provide benefits relating to preexisting conditions for a period of 12 months after enrollment in the plan or 18 months in the case of late enrollment. Title I allows individuals to reduce the exclusion period by the amount of time that they had "creditable coverage" prior to enrolling in the plan and after any "significant breaks" in coverage. "Creditable coverage" is defined quite broadly and includes nearly all group and individual health plans, Medicare, and Medicaid. A "significant break" in coverage is defined as any 63-day period without any creditable coverage. Along with an exception, allowing employers to tie premiums or co-payments to tobacco use, or body mass index.

Title I also requires insurers to issue policies without exclusion to those leaving group health plans with creditable coverage (see above) exceeding 18 months, and renew individual policies for as long as they are offered or provide alternatives to discontinued plans for as long as the insurer stays in the market without exclusion regardless of health condition.

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