How the Health Insurance Portability and Accountability Act (HIPAA) and Other Privacy Laws Affect Public Transportation Operations

Abstract

This research project examines privacy legal issues in public transportation and para-transit services arising from the Health Insurance Portability and Accountability Act (HIPAA) and other privacy laws. Public transportation agencies, including para-transit services, maintain some medical information about their clients. These include application materials filed by clients or their health professionals during the eligibility process; records created during the review of these applications; and databases, updated as service is provided, which record customers’ destinations, including clinics, hospitals, doctors’ offices, and dialysis centers. HIPAA includes a privacy rule that provides federal protections for personal health information held by covered entities. According to guidance available from the United States Department of Health and Human Services, a “covered entity” is: a health care provider that conducts certain transactions in electronic form; a health care clearinghouse; or a health plan. On the face of it, transit agencies that provide public transportation, including para-transit services, would not normally be covered entities and the HIPAA privacy rule would not apply to them. However, many transit agencies have been advised by attorneys that HIPAA does apply, at least for certain types of information. Regardless of whether HIPAA itself applies, various state laws or other federal laws also may limit transit agencies’ ability to share sensitive health-related information. Differing understandings of what HIPAA requires have been known to limit the ability to coordinate Medicaid and Americans with Disabilities Act paratransit trips. There is also an issue of whether basic trip information like origin, destination, date, time, and the need for an accessible vehicle is medical information that triggers HIPAA requirements. This digest should be helpful to attorneys, transit and para-transit providers, medical providers, planners, transit administrators, and the community at large.