On September 23, 2013, new and updated rules for the Health Insurance Portability & Accountability Act go into effect. The rules currently cover health plans, health care clearinghouses and health care providers. Now the rules will extend to business associates of these three parties. This includes contractors and subcontractors. Additional changes include: making it easier for parents and others to give permission to share proof of a child’s immunization with a school; patients will now be able to ask for a copy of their electronic medical record in an electronic form; there are new limits on how information is used and disclosed for marketing and fundraising purposes; and, new prohibitions on the sale of an individuals’ health information without permission.