The Health Insurance Portability and Accountability Act (HIPAA) of 1996 (PL. 104-191) is a multitiered, comprehensive, convoluted, and controversial federal law for sweeping health care reform. Although HIPAA is dramatically broader in scope than privacy protections for health care information, a provision for privacy in the form of a Privacy Rule is included in Title II of HIPAA under the Administrative Simplification regulations; this regulation has created widespread controversy, as well it should, juxtaposed with both civil liberties and the tenets of our profession's ethical code. In this article, the authors contend that concerns about HIPAA and client confidentiality need to be raised by professional organizations so their members become aware of the possible impact of certain HIPAA regulations on their practices. Effort and time need to be focused on an assessment of the content and type of identifiable health information that is shared with managed care and insurance companies. Practitioners need to maintain case files (paper or electronic) that protect their clients from harm. Finally, time, energy, and money need to be directed to filing lawsuits in the federal courts, as in the case of Citizens for Health v. Tommy Thompson, to enjoin the HIPAA regulations that jeopardize the confidentiality of private medical information.