HIPPA; Violations and Penalties
Introduction
Health Insurance is so important for people to have these days. So many people suffer because they cannot afford insurance or they get denied for having pre-existing conditions. There are laws set in place that protect people from being violated or discriminated against. However, things do happen and information gets breached. HIPPA tries to prevent insurance plans from discriminating against individuals and protecting their personal information from the world. Throughout this paper I will explain what HIPAA is, examples of violations employee’s make and how they are penalized for the violations.
What is HIPAA?
The Health Insurance Portability and Accountability Act was enacted in the year of
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HIPAA also bans people from being charged more for health conditions they already have. Some of these health factors include: health statues, previous claims, medical history, or genetic information. HIPAA is a federal law that limits a new employee plan the capability of dismissing coverage for prior circumstances. These conditions involve providing a chance for people to enroll in group health plans if they were involved in life experiences or lose other coverage. HIPAA forbids judgment towards employees and their family based on health problems they face; whether it is previous medical circumstances or genetic problems. HIPPA promises that people have a right to obtain their health records at all times. They may also be able to renew their personal health insurance policies whenever they choose. Helping those with pre-existing health problems before applying for coverage is one of the most beneficial factors that HIPAA provides. HIPAA applies when an insurance plans denies someone insurance for having a condition before applying for coverage. According to HIPAA, a health plan is only permitted to look back 6 months for pre-existing conditions. In detail, the …show more content…
“People can violate the security, administrative or technical safeguards”, (“What Is a HIPAA Violation?"). Sometimes individuals are not even aware that they are violating HIPAA. Patients can set a date of when they want their authorization expired, so a violation would be releasing these records after they have expired. Another violation is not releasing information to patients in a timely matter. HIPAA states that patients have the right to receive copies of their records electronically whenever they want. Employees violate HIPAA when they do not properly get rid of patient’s records. “The HIPAA privacy rule applies to ‘covered entities’, and even though employers are generally not covered entities, they are definitely affected by the rules applying to entities that are covered”, ("HIPAA Privacy Rule”). Theft of personal health information is very common amongst employees. It can vary from talking to others about individual’s personal information to careless mishandling of the material. The majority of HIPAA violations are computer-related breeches. The bare minimum for storing personal information on protected networks is with firewalls. However, employers should go further with additional security measures to continue to regulate employee’s use of personal information. The possibility of a HIPAA violation has increased because of the changes our society has made in the way we communicate. Lack of knowledge does not justify
When confidential patient information is disclosed without consent it is a violation of the HIPAA Title II Security Rule. This rule was enacted in response to private information being leaked to the news and emails containing privileged information were read by unauthorized people. Identity theft is a real concern so patient privacy should be taken seriously. This is a rule can easily be broken without the offender feeling any malice towards the victim for example gossip and curiosity. Gossip in a medical office can have devastating effects on a health care facility’s reputation. Employees engaging in idle chatter to pass the time can inadvertently be overheard by patients or family members. Simply not using the patient’s name may not be enough if the person overhearing the conversation sees the resemblance. Professional behavior should be exercised at all times and juvenile behavior such as spreading gossip, has no place in a business that relies on its credibility. This rule will impact the way patient medical records are handled because we know the seriousness of it. Hospitals that don’t enforce HIPAA rules will have negative repercussions. The patient can have irreversible damage done to their view on the medical field and that hospital if their information is not treated with care. They may even feel so violated that they bring litigation against the hospital.
Since the formed President Bill Clinton signed HIPAA policy in to law, it has been a driving for the healthcare facilities though out the United State. This law has been shaping the healthcare facilities better conditions. HIPAA policy has causes the healthcare facilities to have document in place when a patient is admitted to the hospital seeing physician at clinic or all confidentiality document must be sign up on a admitted. When these documents signed, the patient and the others person who authorized to view any of the documents, for example: Medical records of the patient medication, diseases, tests results, etc.
Overall these sources proved to provide a great deal of information to this nurse. All sources pertained to HIPAA standards and regulations. This nurse sought out an article from when HIPAA was first passed to evaluate the timeline prospectively. While addressing the implications of patient privacy, these articles relate many current situations nurses and physicians encounter daily. These resources also discussed possible violations and methods to prevent by using an informaticist and information technology.
– Health plans; – Health care clearinghouses;. – Health care providers who transmit health information in electronic form for certain standard transactions. Even though HIPAA was signed into law over seven years ago, its effects are mostly being felt now. This is because of its schedule of compliance. * 10/16/2002 - Transactions and code sets * 4/14/2003 – Privacy Rule * 4/14/2003 – Business Associates * 4/20/2005 – Security Rule This delay stems from a provision in the original act stating that if Congress did not specify certain regulations by the end of 1999, the Department of Health and Human Services (HHS) had to do it.
“The Health Insurance Portability and Accountability Act (HIPAA) of 1996 made it illegal to gain access to personal medical information for any reasons other than health care delivery, operations, and reimbursements” (Shi & Singh, 2008, p. 166). “HIPAA legislation mandated strict controls on the transfer of personally identifiable health data between two entities, provisions for disclosure of protected information, and criminal penalties for violation” (Clayton 2001). “HIPAA also has privacy requirements that govern disclosure of patient protected health information (PHI) placed in the medical record by physicians, nurses, and other health care providers” (Buck, 2011). Always remember conversations about a patient’s health care or treatment is a violation of HIPAA. “All PHI is included in the privacy requirements for example: the patient’s past, present or future physical or mental health or condition; the provision of health care to the individual, or the past, present, or future payment for the provision of health care to the individual, and that identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual” (Buck, 2011). Other identifiable health information would be the patient’s name, address, birth date and Social Security Number (Keomouangchanh, 2011). (Word count 197)
Health Insurance Portability and Accountability Act or HIPAA is a statute endorsed by the U.S. Congress in 1996. It offers protections for many American workers which improves portability and continuity of health insurance coverage. The seven titles of the final law are Title I - Health care Access , Portability, Title II - Preventing Health Care Fraud and Abuse; administrative simplification; Medical Liability Reform; Title III – Tax-related Health Provisions; Title IV – Application and Enforcement of Group Health Plan Requirements; Title V – Revenue Offsets; Title XI – General Provisions, Peer Review, Administrative Simplification; Title XXVII – Assuring Portability, Availability and Renewability of Health Insurance Coverage. (Krager & Krager, 2008)
The Health Insurance Portability and Accountability Act, most commonly known by its initials HIPAA, was enacted by Congress then signed by President Bill Clinton on August 21, 1996. This act was put into place in order to regulate the privacy of patient health information, and as an effort to lower the cost of health care, shape the many pieces of our complicated healthcare system. This act also protects individuals from losing their health insurance if they lose their employment or choose to switch employers. . Before HIPAA there was no standard or consistency for the enforcement of the privacy for patients and the rules and regulations varied by state and organizations. HIPAA virtually affects everybody within the healthcare field including but not limited to patients, providers, payers and intermediaries. Although there are many parts of the HIPAA act, for the purposes of this paper we are going to focus on the two main sections and the four objectives of HIPAA, a which are to improve the portability (the capability of transferring from one employee to another) of health insurance, combat fraud, abuse, and waste in health insurance, to promote the expanded use of medical savings accounts, and to simplify the administration of health insurance.
HIPAA is there to help protected all the patients information no matter if is written down, oral and or an electronic record (Stember, 2005). There are more than one HIPAA rules that protect all aspects of the PHI. Some of those rules let the patient take hold of their healthcare. This lets the patient have more control over their health records. HIPAA lets the patient get their records when they want to view them. But they can’t get and medical records that are involved in a criminal or proceeding of any kind, and do not have the right to psychotherapy notes (Green, 2017).
The Health Insurance Portability and Accountability Act passed and were signed into law on August 21, 1996. It affects the medical facility and its day to day operations; in many different ways. HIPAA sets higher standard of operation for healthcare workers and the facilities. "HIPAA was instituted to "improve the portability and continuity of health insurance coverage; to combat waste, fraud, and abuse in health insurance and healthcare delivery; to promote the use of medical savings accounts, to improve access to long term care services and coverage; to simplify the administration of health insurance; and to serve other purposes" (Kinn’s, 2011).
Some of the things that HIPAA does for a patient are it gives patients more control over their health information. It sets boundaries on the use and release of health records. It establishes appropriate guidelines that health care providers and others must do to protect the privacy of the patients’ health information. It holds violators accountable, in court that can be imposed if they violate patients’ privacy rights by HIPAA. Overall HIPAA makes it to where the health information can’t b...
In conclusion, technology has changed the world, as we knew it. Positive and negative come with change. The goal of the ACA, HIPPA, and EHRs is achieve positive patient outcomes, while protecting the integrity, trust and confidentiality, and decreasing health care cost. Privacy is a fundamental right of a patient, and nurses are expected to maintain confidentiality (Burkhardt & Nathaniel, 2014). A breach in confidentiality will result in lack of trust between nurse and patients. As a nurse, it is my responsibility to ensure my patients privacy, and to provide nursing care that is patient centered, not technology centered.
HIPAA provides the first federal protection for the privacy of medical records (Burke & Weill, 2005). HIPPA encourages the use of electronic medical records and the sharing of medical records between healthcare providers, because it can aid in saving lives. HIPAA requires that patients have some knowledge of the use of their medical records and must be notified in writing of their providers' privacy policies. HIPAA has technical requirements that a healthcare provider, insurer, or service provider, unless exempt under state law, must provide. An organization must conduct a self-evaluation to learn what threats its records face, and develop techniques needed to protect the information (HIPAA, 1996).
According to the report provided by the consultant, the employees at this facility were not taking precautions in safeguarding the patient’s health information. Therefore, the employees at this facility were in violation of the Health Insurance Portability and Accountability Act (HIPPA). It is important for employees to understand the form of technology being used and the precautions they must take to safeguard patient information.
The Health and Human Services (HHS) settled a case with Blue Cross Blue Shield of Tennessee (BCBST) for $1.5 million for violating the Health Insurance Portability and Accountability Act (HIPAA) and security rules. There are security issues with BCBST in regard to confidentiality, integrity, availability, and privacy. There are also security requirement by HIPAA which could have prevent the security issue if it has been enforced. There are correction actions taken by BCBST which were efficient and some may have not been adequate. There are HIPAA security requirements and safeguards organization need to implement to mitigate the security risk in terms of administrative, technical, and physical safeguards.
The Health Insurance Portability and Accountability Act (HIPAA), Patient Safety and Quality Improvement Act (PSQIA), Confidential Information and Statistical Efficiency Act (CIPSEA), and the Freedom of Information Act all provide legal protection under many laws. It also involves ethical protection. The patient must be able to completely trust the healthcare provider by having confidence that their information is kept safe and not disclosed without their consent. Disclosing any information to the public could be humiliating for them. Patient information that is protected includes all medical and personal information related to their medical records, medical treatments, payment records, date of birth, gender, and