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Policies > HIPAA > Factsheet
Public Health Implications of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule
Dear Colleague Letter
June 21, 2005

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Public Health Implications of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule

Dear Colleague:

The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule has been in effect since April 14, 2003. The intent of HIPAA is to establish national standards for consumer privacy protection and insurance market reform. Initially, a lack of information and misinterpretation of some HIPAA provisions had a negative impact on the conduct of some time-honored public health activities. In some instances, confusion about the intent and implementation of the rules resulted in health care providers refusing access by public health officials to patient records for immunization assessment and surveillance purposes. The National Immunization Program (NIP) of the Centers for Disease Control and Prevention (CDC) recognizes that providers are concerned about compliance, and they need clear and accurate information about the practical application of the HIPAA Privacy Rule on public health practices.

NIP has worked closely with Health and Human Services (HHS) Office for Civil Rights, which is the lead agency for interpreting and enforcing HIPAA, and the CDC legal counsel to clarify public health provisions of the Privacy Rule and to disseminate information to our partners at the state and local levels. In August 2003, NIP sent the first of a series of guidance statements to Immunization Program Managers and State Epidemiologists in response to states’ requests for clarification regarding access to patient records to conduct VFC and AFIX site visits. The mailing included a one-page HIPAA and Public Health Fact Sheet that provided a brief summary of HIPAA and Privacy Rule definitions, and HIPAA and Public Health Site Visits: Access to Patient Records during AFIX and VFC Visits, a short document containing responses to specific questions asked by the states regarding disclosure of patient health information without prior authorization during VFC and AFIX provider site visits. The CDC Office of General Counsel, which provides legal advice for CDC programs on issues such as implementation of HIPAA, prepared the responses to these questions. These materials have been very effective in addressing providers’ concerns about HIPAA and facilitating traditional public health practice.

Almost two years after the effective date of the Privacy Rule, several states have requested written materials clarifying other questions and concerns about HIPAA. Enclosed is the second in the series of guidance statements, HIPAA and Perinatal Hepatits B Prevention. The original HIPAA and Public Health Fact Sheet is also enclosed. Additional information is available on the Office for Civil Rights website at and in the MMWR, HIPAA Privacy Rule and Public Health: We hope you will find this information helpful as you educate your provider groups and work with your respective legal offices on HIPAA issues.

     (HIPAA Factsheet)
FAQs about HIPAA and Perinatal Hepatits B Prevention)

cc: President, Association of State and Territorial Health Officials
President, Association of Immunization Managers
President, Council of State and Territorial Epidemiologists


Stephen L. Cochi, M.D., MPH

Acting Director

National Immunization Program

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This page last modified on July 5, 2005


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