Health Insurance Portability and Accountability Act 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. Title I of the HIPAA act refers to mostly the group health plans and the restrictions they can place upon the policy holder. In layman’s terms, HIPAA makes sure through Title I, that a third party cannot deny you coverage due to the loss or change in employment. On top of the basic clause, a group plan cannot deny coverage based on your health status, which includes medical history, genetic information, or disabilities. Ti... ... middle of paper ... ...proactive. With the way that HIPAA was drafted, then add the possible penalties for violators, lead physicians and medical facilities to withold information from individuals who have a right to it. After reviewing the rules of the HIPAA, the legislation found health care providers were unsure of their legal privacy responsibilities and often responded with an overly guarded approach to disclosing information. To date these rules are still confusing and need to made clearer. References Medical Law and Ethics 4th edition, Bonnie F. Fremgen PhD, (2012, 2009, 2006, 2002) Mosby’s Dictionary of Medicine 8th edition, (2009) Health Insurance Today: A Practical Approach 3rd edition, Janet I. Beik (2011) www.health.howstuffworks.com www.ehow.com/facts www.all-things-medical-billing.com/history www.geomarcomputers.com/hipaa www.hhs.gov/ocr/privacy/hippa
How would you like to keep track of your personal health information record in your computer at home? The electronic data exchange was one of the goals of the government to improve the delivery and competence of the U.S. healthcare system. To achieve this plan, the U.S. Congress passed a regulation that will direct its implementation. The Department of Health and Human Services is the branch of the government that was assigned to oversee the HIPAA rules. The Health Insurance Portability and Accountability Act (HIPAA) of 1996 is a national public law in the United States that was created to improve health insurability, prevent insurance abuse and to protect the privacy and security of a person’s health information.
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.
It was passed partly because of the failure of congress to pass comprehensive health insurance legislation earlier in the decade. The general goals of HIPAA are to: * Increase number of employees who have health insurance; * Reduce health care fraud and abuse; * Introduce/implement administrative simplifications in order to augment effectiveness of health care in the US; * Protect the health information of individuals against access without consent or authorization; * Give patients more rights over their private data; * Set better boundaries for the use of medical information; * Hold people accountable for misuse; * Encourage administrative simplification (in the form of digitalization of information) to help reduce costs. HIPAA affects covered entities which are defined as: – Health plans; – Health care clearinghouses; – Health care providers who transmit health information in electronic form for certain standard transactions. Even though HIPAA was singed into law over seven years ago, its effects are mostly being felt now.
“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)
The central portion addresses the portability and continuity of care and the prevention of fraud and protection of privacy. Group health plans may not deny any individual coverage because of preexisting medical condition for more than 12 to 18 months after an individual’s enrollment date. Title I allows individuals to reduce the exclusion period by the amount of coverage time before enrolling without breaks in coverage for over 62 days. Also, Title I provides special enrollment rights to individuals who lose their health coverage under certain while circumstances such as separation, divorce, death, loss of employment and reduction in hours. (http://hipaa.ohio.gov/whitepapers/title1healthcareaccess.PDF)
HIPAA and fraud & abuse tie together in the way HIPAA protects the use the PHI in the billing and coding of claim form. No matter if the patient sells their information, HIPAA is there to help protect against fraud and abuse. One way HIPAA helps prevent fraud and abuse is in the case of preforming an audit. Although the government is the top payer in the US. Payers are the ones who do the audit of the offices. They make sure that what is on the claim matches what is on the patient’s record. This is how fraud and abuse can be stopped from continuing on.
HIPPA Privacy Rules were established to protect health information that may be used or disclosed by covered entities for research trial purposes. HIPPA Privacy Rules define research as a systematic investigation, including research development, testing, and evaluation, designed to develop or contribute to generalized knowledge (“Research,” HHS.gov, June 5, 2013). Privacy Rule established regulation guidelines to inform research volunteers on how medical information for research purposes will be utilized. Guidelines and right to access medical information held by researching entity are also covered in the HIPPA Privacy Rule. Countermeasures to establish protection of identifiable individual health information during research are extremely important,
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).
HIPAA is the federal Health Insurance Portability and Accountability Act of 1996. The primary goal of the law is to make it easier for people to keep health insurance, protect the confidentiality and security of healthcare information ad help the healthcare industry control administrative costs. HIPAA stands for the Health Insurance Portability and Accountability Act of 1996. HIPAA was first introduced in 1996. It was made a law by the United States Congress and signed by President Bill Clinton. The HIPAA Privacy Rule protects an individual’s medical records and other personal health information.
They also include employer-sponsored group health plans, government and church-sponsored health plans, and multiemployer health plans (hhs). There are exceptions—a group health plan with less than fifty50 participants that is administered solely by the employer that established and maintains the plan is not a covered entity (hhs). Two types of government-funded programs are not health plans: (1) those whose principal purpose is not providing or paying the cost of health care, such as the food stamps program; and (2) those programs whose principal activity is directly providing health care, such as a community health center,5 or the making of grants to fund the direct provision of healthcare (hhs). Certain types of insurance entities are also not health plans, including entities providing only workers’ compensation, automobile insurance, and property and casualty insurance (hhs). If an insurance entity has separable lines of business, one of which is a health plan, the HIPAA regulations apply to the entity with respect to the health plan line of business
Since this legislation anticipates a massive expansion in the exchange of electronic protected health information (Healthcareitnews,2015)., modifications were made in the Hipaa privacy and security rule under the Hitech act, which made the Hipaa compliance on privacy and security a lot stricter, with fines for restrictions on the use of personal data and data breaches not only for providers, but also hold their business associates and covered entities liable for any security breach.
Patient Protection and Affordable Care Act is the real title of the bill, enacted in 2009. It is far better known as The Affordable Care Act or Obamacare. This bill represents the biggest revolution and improvement, or at least an attempt towards it, in the health care of the United States of America since the passage of Medicaid and Medicare in 1965. The main purpose of the ACA implementation was, as the bill states in its title, to make: ˝ Quality, Affordable Health Care for All Americans˝ possible. Before the ObamaCare, there were millions of American who were uninsured, or had poor quality insurance plan. On the other hand those who did have health care coverage, even the decent one, we left on their own when insurance companies abused their trust and deprived them of their rights. That was the reason why the government and the President Obama, hoped to increase the quality and make the health insurance more affordable. The idea was to lower uninsured rate by firstly increasing the extent of public and also private coverage, and then secondly, to minimise the costs of health care for both individuals and the government.
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 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