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HIPAA Identity theft has always been in the back of my mind whenever I use my debit card but I wasn’t too concerned about my health information until I learned about HIPAA. It is a very important set of rules and standards that protects our privacy. 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 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) Because of the major infl... ... middle of paper ... ...lion. Penalties are adjusted for violations corrected with the required time period. (AMA, n.d) Works Cited AMA. (n.d). http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/hipaa-violations-enforcement.page April, 2002: http://hipaa.ohio.gov/whitepapers/title1healthcareaccess.PDF Center for Medicare and Medicaid Services. (n.d). https://www.cms.gov/TransactionCodeSetsStands/ Jeffries, M. (n.d). Health Insurance Portability and Accountability Act . Retrieved from http://health.howstuffworks.com/medicine/healthcare/insurance/hipaa3.htm Krager, D., & Krager, C. H. (2008). HIPAA for Health Care Professionals. Clifton Park, NY: Delmar. U.S. Department of Health and Human Services. (n.d). http://www.hhs.gov/ocr/privacy/hipaa/understanding/srsummary.html
What is HIPAA? The Health Insurance Portability & Accountability Act of 1996 (HIPAA) was passed by the U.S. Congress to improve portability and continuity of health insurance coverage; to combat waste, fraud and abuse in health insurance; to reduce costs and the administrative burdens by improving efficiency and effectiveness of the health care system by standardizing the interchange of electronic data; and to ensure the pri...
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.
The Consolidated Omnibus Budget Reconciliation Act (COBRA) supports workers, who have lost the right to their health benefits, so that they can keep their employer-sponsored group health plan in force. The need for continued insurance coverage is necessary when coverage is interrupted due to the loss of a job, reduced working hours, death of the insured employee, divorce or even other circumstances that affect a person’s life. A person who qualifies for the group health benefit is usually expected to pay for that premium. The employer may increase the premium up to 102 percent, which is allowed under the provisions of COBRA. The law applies to all employer-sponsored group plans who have 20 and above employees and urges them to ensure an extension of the health coverage that is temporary (Magill, 2009).
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.
. HIPAA privacy rules are complicated and extensive, and set forth guidelines to be followed by health care providers and other covered entities such as insurance carriers and by consumers. HIPAA is very specific in its requirements regarding the release of information, but is not as specific when it comes to the manner in which training and policies are developed and delivered within the health care industry. This paper will discuss how HIPAA affects a patient's access to their medical records, how and under what circumstances personal health information can be released to other entities for purposes not related to health care, the requirements regarding written privacy policies for covered entities, the training requirements for medical office employees and the consequences for not following the policy.
“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)
US Congress created the HIPAA bill in 1996 because of public concern about how their private information was being used. It is the Health Insurance Portability and Accountability Act, which Congress created to protect confidentiality, privacy and security of patient information. It was also for health care documents to be passed electronically. HIPAA is a privacy rule, which gives patients control over their health information. Patients have to give permission any health care provider can disclose any information placed in the individual’s medical records. It helps limit protected health information (PHI) to minimize the chance of inappropriate disclosure. It establishes national-level standards that healthcare providers must comply with and strictly investigates compliance related issues while holding violators to civil or criminal penalties if they violate the privacy of a person’s PHI. HIPAA also has boundaries for using and disclosing health records by covered entities; a healthcare provider, health plan, and health care clearinghouse. It also supports the cause of disclosing PHI without a person’s consent for individual healthcare needs, public benefit and national interests. The portability part of HIPAA guarantees patient’s health insurance to employees after losing a job, making sure health insurance providers can’t discriminate against people because of health status or pre-existing condition, and keeps their files safe while being sent electronically. The Privacy Rule protects individual’s health information and requires medical providers to get consent for the release of any medical information and explain how private health records are protected. It also allows patients to receive their medical records from any...
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 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.
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
Throughout all things medical, privacy is most important. The concern here is why camera crews are allowed into a facility that is supposed to make you feel like you’re protected. A person has the right to themselves, so who determines whether or not you have that right? Just because a person is unconscious doesn’t mean their privacy should be invaded. Whether unconscious or not, consent was not formally, or previously agreed too. There are many factors at play here, but I will be touching on those a little more throughout the essay. Privacy sticks out to me in an important way, without it we all would know every little detail of everyone’s lives.
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.
These are called the “participatory wellness plans.” Individuals enrolled in this program do not need any of the HIPAA nondiscriminatory requirements other than the ones described. The most typical examples of the participatory wellness plans include membership of a gym and tobacco cessation programs (Gowrisankaran, 2013).