HIPAA: WHAT TO EXPECT

Now that the provisions of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 are in place, what can you expect in terms of privacy related to your cancer diagnosis and treatment?

First, understand that all the HIPAA safeguards apply equally to anyone with a serious health condition—whether it's cancer, heart disease, liver disease or a host of other ailments. Any type of health condition falls into the "protected health information" category under HIPAA.

Among other provisions, HIPAA guarantees access to health insurance—as well as the ability to tote it to another job—and prohibits discrimination based on health status. HIPAA also gives you rights over your health information and sets rules and limitations on who can look over your health information.

Among the safeguards in place, mandated by the law, that you can feel comfortable your employer is following:

• No disclosure of health information without your permission. Your human resources staff, for instance, can't give anyone information until someone has obtained your OK.
• The health information must be limited. Only details that are absolutely necessary for the other party—whether the other party is an insurance company, a doctor or other--to know can be transmitted.
• Adoption of policies and procedures to safeguard health information. If your employer sponsors a self-funded plan, he must train the work force on the new policies, have a privacy complaint procedure in place and take "reasonable precautions" to be sure your information is secure. You should expect that only a limited number of employees have access to the health information files. If a variety of people seem to be handling your health information, you might ask exactly who has authorization to manage it. The employers agree to establish adequate "fire walls" to protect the privacy of your health information.

In addition, there are a number of measures you can take as an employee to be sure you're getting full benefit of the law:

• Less is more. When you are talking to your human resources representative or your boss, remember you aren't talking to your health care team. They don't need to know everything. Focus on answering questions as straightforwardly as possible; don't ramble. If they want more information, let them ask.
• Think through some of the procedures you are asked to do and whether your cancer treatment or diagnosis will affect your action. Suppose it is a workplace that does regular drug screening. You should ask your HR professional (as well as your physician) if cancer medications can affect the test results.
• Expect to be asked permission to release information. If you go to HR and ask them to call your health plan about a claim that hasn't been paid in a timely manner, you should expect to first sign a disclosure form granting permission for them to ask about the tardy payment, for instance.
• If you aren't certain if you are telling too much, role play first. You might rehearse with your physician or a friend familiar with the new law.
• Keep yourself updated. The U.S. Department of Health and Human Services Office for Civil Rights (www.hhs.gov/ocr) has consumer information sheets on the site about HIPAA as well as a valuable section on frequently asked questions.