Increase Text Size
Decrease Text SizeHIPAA Privacy Rules
The HIPAA Privacy Rules were designed to protect the confidentiality of patient records. At the same time, the rules are intended to give patients easier access to their own medical information.
The HIPAA rules have sometimes made it more difficult for benefits counselors and beneficiary advocates to communicate with medical providers and insurers in order to obtain needed information or resolve problems. In the context of Part D, the CMS Office of Civil Rights has issued clear directives as to when plans may discuss issues with counselors and others who seek to help beneficiaries with Part D issues.
HIPAA Privacy Regulation
The HIPAA Privacy rules are contained in federal regulation and have many legal provisions that can be helpful in to benefits counselors and advocates.
- The entire HIPAA regulation is here.
- HIPAA Privacy Regulation Summary (372Kb PDF file)
A summary of the privacy rules from the CMS Office of Civil Rights. - Part D Counseling and HIPAA Privacy Rules
The CMS Office of Civil Rights has issued clear directive to Part D plans about when they may discuss issues with benefits counselors who seek to help beneficiaries with Part D issues. - A patient who believes her privacy rights were violated may file a complaint with the Office of Civil Rights. Here you can find out how to file such a complaint (72Kb PDF file).
Educational Resources
“Advocacy in a Post HIPAA World”, BiFocal, Vol. 25, Number 2, Winter 2004 (129Kb PDF file)
This 2004 article in the American Bar Association Commission on Law and Aging publication “BiFocal” explains how the privacy rules affect beneficiary counseling and advocacy.
