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This Web site contains a compilation of more than a thousand consumer finance  columns written by Tony Novak from the 1980s through 2006, updated and reformatted for maximum usefulness today.  New material was added after 2010.

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Enforcement of HIPAA laws

originally posted: 11/22/2006  reposted: 2/18/2011 This post has not been recently reviewed or revised by the author and may be out of date. If you notice an error or are in doubt, please send a new question by email or ask for an update. Email

Q: My family had medical insurance through my husband's employer to January 30,2005 when he was laid-off. I immediately got coverage through my employer with no lapse of coverage. My insurance (Medcost) requested a certificate of credible coverage before processing any claims we submitted. I requested this from our previous insurance (CIGNA) and was sent a form with incorrect dates on it. We have been requesting a corrected certificate of coverage since February 2005 with no success. Meanwhile, Medcost has not been able to process our claims without this information. We have contacted CIGNA's customer service numerous times, have had conversations with and promises from the vice president of customer service, and have contacted CIGNA' s legal department all with no results. What can we do to get this certificate of credible coverage before the year is out (since we understand that it is a Federal requirement that we receive this documentation)?

A: The U.S. Department of Health and Human Services handles complaints of violations of the Health Insurance Portability and Accountability Act (HIPAA). You can submit a complaint for failure to provide an accurate Certificate of Continued Coverage online at . To handle any preliminary questions, you can call the HIPAA Hotline at 1-866-282-0659 or submit your questions to CMS' HIPAA email address at Because the penalties for non-compliance with this federal HIPAA law are so severe, an insurance company would only persist if they were absolutely clear that they were not in error. This makes me think that something in the facts may not be as clear as you presented. In fact, there is no know case of failure to provide an accurate Certificate of Continued Coverage.


More resources:

Understanding a Certificate of Creditable Coverage