ANSWER
from U.S. law, the Health Insurance
Portability and Accountability Act Introduced in 1996,
and also to a set of standards and regulations passed later to
implement the law.
Sarbanes-Oxley Act and
the Health Insurance Portability and Accountability
Act
- The Health Insurance Portability and Accountability Act of 1996
required the Secretary of the U.S. Department of Health and Human
Services (HHS) to develop regulations protecting the privacy and
security of certain health information. To fulfill this
requirement, HHS published what are commonly known as the HIPAA
Privacy Rule and the HIPAA Security Rule. The Privacy Rule, or
Standards for Privacy of Individually Identifiable Health
Information, establishes national standards for the protection of
certain health information.
- Some health care plans are exempted from Title I requirements,
such as long-term health plans and limited-scope plans like dental
or vision plans offered separately from the general health plan.
However, if such benefits are part of the general health plan, then
HIPAA still applies to such benefits. For example, if the new plan
offers dental benefits, then it must count creditable continuous
coverage under the old health plan towards any of its exclusion
periods for dental benefits.
- An alternate method of calculating creditable continuous
coverage is available to the health plan under Title I. That is, 5
categories of health coverage can be considered separately,
including dental and vision coverage. Anything not under those 5
categories must use the general calculation (e.g., the beneficiary
may be counted with 18 months of general coverage, but only 6
months of dental coverage, because the beneficiary did not have a
general health plan that covered dental until 6 months prior to the
application date). Since limited-coverage plans are exempt from
HIPAA requirements, the odd case exists in which the applicant to a
general group health plan cannot obtain certificates of creditable
continuous coverage for independent limited-scope plans, such as
dental to apply towards exclusion periods of the new plan that does
include those coverages.