HIPAA Case Analysis

Title IV of HIPAA specifies conditions for group health plans regarding coverage of persons with pre-existing conditions, and modifies continuation of coverage requirements.

Title V of HIPPA includes provisions related to company-owned life insurance, treatment of individuals who lose U.S. Citizenship for income tax purposes and repeals the financial institution rule to interest allocation rules. It also amends provisions of the law relating to people who give up United States citizenship or permanent residence, expanding the expatriation tax to be assessed against those deemed to be giving up their U.S. status for tax reasons, and making ex-citizens ' names part of the public record through the creation of the Quarterly Publication of Individuals

The law strengthen existing HIPAA regulations, elimination pre-existing Conditions that previously allowed insurance providers to discrimination or preclude from converging patients with existing conditions under the Affordable Care Act. However, under the current law health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts. They also can’t charge women more than men. These rules went into effect for plan years beginning on or after January 1, 2014.

In addition, Preventive Care is being encourage to address issues before they become critical later, all at no additional cost to you the patient. Cap insurance company non-medical, administrative expenditures – Insurance companies can’t spend more than 80% of premium dollars on non-medical costs. If they do, you get a rebate. (85% in large group

• Implement appropriate security measures to address the risks identified in the risk analysis.

• Document the chosen security measures and, where required, the rationale for adopting those measures.

• Maintain continuous, reasonable, and appropriate security protections. Risk analysis should be an ongoing process, in which a covered entity regularly reviews its records to track access to e-PHI and detect security incidents, periodically evaluates the effectiveness of security measures put in place, and regularly reevaluates potential risks to e-PHI.
The technical safeguards requires that covered entities implement the following:
• Access Control – Policies and procedures that allow only authorized persons to access electronic protected information.

• Audit Controls – Hardware, software, and/or procedural mechanisms to record and examine access and other activity in information systems that contain or use electronic protected information

• Transmission Security – Implement technical security measures that guard against unauthorized access to electronic protected information that is being transmitted over an electronic network.