April 18, 2012

The Health Insurance Portability and Accountability Act of 1996, Pub. L. 104-191, is a piece of legislation that many of us have had to deal with.  It is codified beginning at 29 USCA 1181, with important regulations starting at 45 CFR 106.101 and continuing through much of the rest of that title.  It raises a lot of questions for medical providers (and a few questions for entities seemingly disconnected from the medical trade), but one of the most fascinating questions for me has always been: why do some people abbreviate it with two Ps?

A search in Allcases for H.I.P.A.A. (the periods are rarely used, but you would miss a few cases if you didn’t include them) finds 1773 results.  But a similar search for H.I.P.P.A. finds 599 results, despite the fact that there is only a single P in the name of the act.  Perhaps some of these are mere typos, but if you run H.I.P.P.A. % H.I.P.A.A., there are still 393 cases using only the mistaken acronym, with no mention of the original (some of these, it bears mentioning, are older, pre-HIPAA cases with a party name that appears similar, but a quick look at the result list shows that not all of the errors are of that sort).  I even tracked down 98 cases that use different acronyms within a paragraph of one another (H.I.P.A.A. /p H.I.P.P.A.).*

The earliest** case using the second P is Wright v. Combined Ins. Co. of America, 959 F.Supp. 356, from February 3, 1997.  Note, however, that WestlawNext seems to know what we’re looking for.  The following query pulled from Wright higlights “HIPPA” as well as “HIPAA.”

In HIPPA, the undersigned cannot find any “manifest congressional intent” to create a new federal cause of action which is removable to federal court….delivers the following results

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There is at least one earlier misspelling, from a 1996 article in the Health Lawyer (available at 9 No. 3. Health Law. 16).

The mistaken acronym is sometimes even expanded into a full mistaken name for the act with the different “Ps” standing for some mix of ‘privacy,’ ‘protection’ and ‘portability.’  A locate within the earlier H.I.P.P.A. results for “health /s information /s privacy portability /s protection” yields 26 results.  Of those, one, the opinion in Boese v. Slaughter, 2007 WL 1071924, bears mention, as it goes out of its way to tell the reader HIPPA is, to quote Magistrate Judge Strong, an ‘inaccurate acronym.’


*A few cases even refer to H.I.P.P.A.A.

**This is easily determined by running H.I.P.P.A. with a shifting date restrictor, which just means using a date restrictor and moving the relevant date a few years at a time until you get a manageable result list. H.I.P.P.A. finds 596 in allcases, but adding da(bef 2000) finds only 34, and changing it to 1998 takes that down to 31, most of which are pre-HIPAA references to someone with the last name ‘Hipp.’