The Health Insurance portability and Accountability Act was first introduced in 1996. This law became nationally known as HIPAA. “This law is made up of five sections. Titles I, III, IV, and V address regulation of the continuity and renewability of employee health insurance, promote the establishment and use of medical savings accounts, and set standards for the coverage of long-term care.” (Charles R. McCornell, 2015, pg 513) HIPAA set guidelines for a lot of aspects in the American health care system. “This law addresses a variety of issues related to health care. HIPAA required the US Department of Health and Human Services to adopt standards regarding the electronic exchange, privacy, and security of health information.” (Health Insurance …show more content…
McCornell, 2015, pg 523) Hipaa controls a major patk of health care and affects almost every aspect of …show more content…
(Charles R. McCornell, 2015, pg 514) This title is the one that has had the most affect on patients and healthcare systems. “The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA, Title II) require the Department of Health and Human Services to establish national standards for electronic health care transactions and national identifiers for providers, health plans, and employers. It also addresses the security and privacy of health data.” (HIPAA Title Information, 2015, par 2) Switching over to electronic forms allows for administrative simplification, and the codes used for each location, individual, insurance helps reduce
Membership Services (MSD) at Kaiser Permanente used to be a modest department of sixty staff. However, over the past few years the department has doubled in size, creating minor departmental reorganization. In addition the increase of departmental staffing, several challenges became apparent. The changes included primary job function, as well as the introduction of new network system software which slowed down the processes of other departments. These departments included Claims (who pay the bills for service providers outside of the Kaiser Permanente network), and Patient Business Services (who send invoices to members for services received within Kaiser Permanente). Due to the unforeseen challenges created by the system upgrade, it was decided that MSD would process the calls for both of the affected departments. Unfortunately, this created a catastrophic event of MSD receiving numerous phone calls from upset members—who had received bills a year after the service had been provided. The average Monday call volume had risen from 1,800 to 2,600 calls per day. The average handling time for each phone call had risen as well—from an acceptable standard of 5.6 minutes to an unfavorable 7.2 minutes. The department continued to be kept inundated with these types of calls for the two years that these changes have been effect.
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...
Why is important for the HIPAA and the Bill of Right work in the healthcare system.
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 federal government has taken a stance to standardized care by creating incentive programs that are mandated under the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009. This act encourages healthcare providers and healthcare institutions to adopt Meaningful use in order to receive incentives from Medicare and Medicaid. Meaningful use is the adoption of a certified health record system that acquires or obtains specified objectives about a patient. The objectives or measures are considered gold standard practices with the EHR system. Examples of the measures include data entry of vital signs, demographics, allergies, entering medical orders, providing patients with electronic copies of their records, and many more pertinent information regarding the patient (Friedman et al, 2013, p.1560).
“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)
Health Information Technology for Economic and Clinical Health Act consists of several subtitles. The subtitle D of the Health Information Technology for Economic and Clinical Health Act deals with the privacy and security issues that are associated with the electronic transmission of health information. The Health Information Technology for Economic and Clinical Health Act requires that as of 2011 all healthcare providers are going to be presented with the opportunity of financial incentives for showing meaningful use of electronic health records (EHRs). The proposed incentives will be offered up until 2015 and after that, penalties may occur for the failure of representing the use of EHR. The Health Information Technology for Economic and Clinical Health Act even started grants for the training centers for all staff members that are required to support a health information technology infrastructure. (www.healthcareitnews.com).
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.
Portability can improve patient care. Patients no longer have to “tote” their cumbersome medical records around anymore. EHR’s give physicians and clinicians access to critical healthcare information in the palm of their hand, which ultimately leads to improved patient care outcomes. EHR’s also provide security to vital medical and personal healthcare information. Organizations like HIPPA defines policies, procedures and guidelines for preserving the privacy and security of discrete distinguishable health information (HHS.gov,
The amount of money that is spent on healthcare is a quite a bit of money but about 10% of all the money is a result of some sort of medical fraud or abuse. This is about 120 billion dollars. With HIPAA (Health Insurance Portability and Accountability Act) medical fraud and abuse can be tracked easier. HIPAA was enacted in august of 1996; this was to help improve the portability and continuity of the health insurance.
The United States (U.S.) has a health care system that is much different than any other health care system in the world (Nies & McEwen, 2015). It is frequently recognized as one with most recent technological inventions, but at the same time is often criticized for being overly expensive (Nies & McEwen, 2015). In 2010, President Obama signed the Patient Protection and Affordable Care Act (ACA) (U. S. Department of Health & Human Services, n.d.) This plan was implemented in an attempt to make preventative care more affordable and accessible for all uninsured Americans (U.S. Department of Health & Human Services, n.d.). Under the law, the new Patient’s Bill of Rights gives consumers the power to be in charge of their health care choices. (U.S. Department of Health & Human Services, n.d.).
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.
U.S. Department of Health and Human Services, Health Information Privacy. (n.d.). Is the use of encryption mandatory in the security rule? Washington, DC: Retrieved from http://www.hhs.gov/ocr/privacy/hipaa/faq/securityrule/2001.html
The implementation of electronic health records (EHR) continues to make an impact on nursing and patient care throughout the country. As a part of the American Recovery and Reinvestment Act of 2009, all public and private healthcare providers were required to implement electronic health records in their facilities by January 1, 2014. By demonstrating “meaningful use” of the electronic medical record, facilities are able to maintain Medicaid and Medicare reimbursement levels. Providers who show that they are meeting the “meaningful use” criteria during EHR use will receive an incentive payment from Medicare and Medicaid. “Meaningful use” is “using certified technology in EHR implementation to improve quality, safety, efficiency, and reduce health disparities; engage patients and families; improve care coordination; and maintain privacy and security of patient health information” (Centers for Medicare & Medicaid Services, 2013).