Our case assignment deals with Dr. Williams a recent medical school graduate who is licensed and meets the requirements to legally practice medicine. Graduating from an overseas medical school made it difficult finding employment so he chose to operate a medical clinic providing abortion services based on a very profitable clinic operated by a former classmate and friend. Prior to leaving my job as his assistant I witnessed a patient, Joan, suffer an injury resulting from an error by Dr. Williams. In anticipation of Joan filing a lawsuit Dr. Williams shows Joan’s medical records to a friend and asks for advice. His friend tells him to contact his medical malpractice insurance carrier. Has there been a HIPAA violation? Is Dr. Williams subject to criminal prosecution and what penalties could he face? Understanding HIPAA regulations, federal and state laws and violations, then applying them to Dr. Williams’ case provides the answers.
The Health Insurance Portability and Accountability Act of 1996
Enactment of HIPAA guaranteed health insurance coverage portability and directing the Department of Health and Human Services (DHHS) to implement the national standard for electronic healthcare transactions. The HIPAA Privacy Rule (Standards for Privacy of Individually Identifiable Health Information) was adopted when it was determined that developing technology would soon place certain individually identifiable health information or protected health information (PHI) at a greater risk of disclosure. Oversight and enforcement of the Privacy Rule and regulating the use and disclosure of PHI by covered entities falls to the Office of Civil Rights (OCR) under DHHS (Office for Civil Rights, Health Information Privacy, 2011). Compla...
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.... The New England Journal of Medicine 2007;356: 2713-9. Retrieved June 1, 2011, from https://secure.muhealth.org/~ed/students/articles/NEJM_356_p2713.pdf
Medical Errors and Patient Safety. (2008). The Patient Safety and Quality Improvement Act of 2005. Agency for Healthcare Research and Quality website. Retrieved May 31, 2011, from http://www.ahrq.gov/qual/psoact.htm.
Office for Civil Rights, Health Information Privacy. (2011). Understanding Health Information Privacy. U.S. Department of Health & Human Services website. Retrieved May 30, 2011, from http://www.hhs.gov/ocr/privacy/hipaa/understanding/index.html.
Office for Civil Rights, Privacy Brief. (2003). Summary of the HIPAA Privacy Rule. U.S. Department of Health & Human Services website. Retrieved May 30, 2011, from http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/privacysummary.pdf.
The flip side of the signing a confidentiality document under HIPAA policy healthcare officials many times has been frustrated because bounds they can’t cross. Many times family or friends who aren’t authorizes obtains valuable medical information are coming all hours of the day to ask for critical medical reason, the nurses, physicians and others officials bid my law not to get out information on the telephone, or in personal if the individual or individuals name aren’t on the privacy document. Having a ...
As the evolution of healthcare from paper documentation to electronic documentation and ordering, the security of patient information is becoming more difficult to maintain. Electronic healthcare records (EHR), telenursing, Computer Physician Order Entry (CPOE) are a major part of the future of medicine. Social media also plays a role in the security of patient formation. Compromising data in the information age is as easy as pressing a send button. New technology presents new challenges to maintaining patient privacy. The topic for this annotated bibliography is the Health Insurance Portability and Accountability Act (HIPAA). Nursing informatics role is imperative to assist in the creation and maintenance of the ease of the programs and maintain regulations compliant to HIPAA. As a nurse, most documentation and order entry is done electronically and is important to understand the core concepts of HIPAA regarding electronic healthcare records. Using keywords HIPAA and informatics, the author chose these resources from scholarly journals, peer reviewed articles, and print based articles and text books. These sources provide how and when to share patient information, guidelines and regulation d of HIPAA, and the implementation in relation to electronic future of nursing.
Introduction The Health Insurance Portability and Accountability Act of 1996, or HIPAA, is a law designed “to improve portability and continuity of health insurance coverage in the group and individual markets, to combat waste, fraud, and abuse in health insurance and health care 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 for other purposes. ”1 HIPAA mandates that covered entities must employ technological means to ensure the privacy of sensitive information. This white paper intends to study the requirements put forth by HIPAA by examining what is technically necessary for them to be implemented, the technological feasibility of this, and what commercial, off-the-shelf systems are currently available to implement these requirements. HIPAA Overview On July 21, 1996, Bill Clinton signed HIPAA into law.
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)
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.
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...
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Keeping patients safe is essential in today’s health care system, but patient safety events that violate that safety are increasing each year. It was only recently, that the focus on patient safety was reinforced by a report prepared by Institute of medicine (IOM) entitled ” To err is human, building a safer health system”(Wakefield & Iliffe,2002).This report found that approx-imately 44,000 to 98,000 deaths occur each year due to medical errors and that the majority was preventable. Deaths due to medical errors exceed deaths due to many other causes such as like HIV infections, breast cancer and even traffic accidents (Wakefield & Iliffe, 2002). After this IOM reports, President Clinton established quality interagency coordination task force with the help of government agencies. These government agencies are responsible for making health pol-icies regarding patient safety to which every HCO must follow (Schulman & Kim, 2000).
It is shocking to know that every year 98000 patients die from medical errors that can be prevented(Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.), 2000). Medical errors are not a new issue in our healthcare system; these have been around for a long time. Hospitals have been trying to improve quality care and patients safety by implementing different strategies to prevent and reduce medical errors for past thirty years. Medical errors are the third leading cause of death after heart disease and cancer in America (Allen, 2013). In addition medical errors are costing our healthcare system an estimated $735 billion to $980 billion (Andel, Davidow, Hollander, & Moreno, 2012).
Ed. David Zieve. U.S. National Library of Medicine, 26 Feb. 2014. Web. The Web.