...A Critical Regulatory Issue in Health Care A Critical Regulatory Issue in Health Care Congress grants agencies the ability to create regulations to promote and carry out public policy (Fremgen, 2012). A critical health care regulatory issue in today’s world is The Privacy and Security Rule. The Privacy Rule, 45 CFR (Code of Federal Regulations) Part 160 and Subparts A and E of Part 164 govern the privacy of individually identifiable health information and the security of electronic individually identifiable health information. CFR 45 Part 160 is otherwise known as the Health Insurance Portability and Accountability Act (HIPAA) (U.S. Department of Health and Human Services, 2012). HIPAA enacted in 1996, outlines the conditions protected health information (PHI) may be used or released by covered entities or individuals. The Office for Civil Rights (OCR) of the Department of Health and Human Services (HHS) enforces the HIPAA Privacy Rule. The Privacy Rule, modified in 2002 and 2003, set standards for protecting the integrity and confidentiality of PHIs covered entities must follow. Medical organizations and their employees have a legal and ethical responsibility to protect patients’ medical privacy at all times. Health care facilities and employees who fail to implement effective privacy rules and regulations are subject to fines, accreditation problems, and possible suits from affected individuals. Facilities and government agencies are liable to HHS for fines but also the...
Words: 815 - Pages: 4
...Health Insurance Portability and Accountability Act Compliance Guide US Department of Health and Human Services Information Security Program Health Insurance Portability and Accountability Act (HIPAA) Compliance Guide September 14, 2005 Page i Health Insurance Portability and Accountability Act Compliance Guide US Department of Health and Human Services Table of Contents Table of Contents .......................................................................................... i Preface.........................................................................................................iii Document Change History ............................................................................iv 1. Introduction ....................................................................................... 1 1.1 1.2 1.3 1.4 2. 2.1 Purpose ........................................................................................... 1 Background...................................................................................... 1 Scope.............................................................................................. 2 Document Organization ..................................................................... 4 HIPAA Administrative Simplification Requirements ........................... 5 General Overview ............................................................................. 5 2.1.1 HIPAA Administrative Simplification Goals and Objectives ............. 5...
Words: 12363 - Pages: 50
...the privacy of medical information. Patient’s information was accessible to employers in some cases, and also to people issuing loans to these individuals. Patients reveal intimate details in confidence to their health care providers, which were normally stored in locked file cabinets, and on shelves in medical records department, now records are stored in data files and may be seen by hundreds of strangers in health service, insurance companies and any organization affiliated with health service. HIPPA Privacy Rule made it possible for all patients to see, copy and request to amend their own medical records. It provides federal protection for patient’s health information. With the Privacy Rule patients must be notify about who their medical information is disclosed to. Patients can also find out who access their medical records for the prior six years. Under the HIPPA Privacy Rule only minimum information should be disclosed to accomplish the intended purpose and a complaint can be filed if there is a violation of privacy. The Privacy Rule only applies to health plans, health care clearinghouses, and to any health care provider who transmits health information in electronic form in connection with transactions for which the Secretary of Health and Human Services has adopted standards under HIPAA. The Health Insurance Portability and Accountability Act of 1996, was enacted on August 21, 1996. Sections 261 through 264 of HIPAA require the Secretary of Health and Human Services...
Words: 2769 - Pages: 12
... The impact of HIPAA on the delivery of human services! I have been a medical assistant for 15 years and HIPAA is a regulation/law that I have had to read over and over again. HIPAA stands for Health Insurance Portability and Accountability Act, this act was passed in 1996 two year after that I became a medical assistant. HIPAA requires the United States health and human services to issue rules protecting the privacy of medical information. This information can be found on the Health and Human Service website. www.hhs.gov The HIPAA privacy rules were issued by the HHS to cover a number of types of companies and can affect human service organizations as health care providers, business associates or employers. The purpose of the rational of this act is to prevent any human service organization covered by the rule from sharing personal medical information without removing all details that could be used to identify the person . For example, a doctor's office that put a patient's name and medical history up on its website would be in violation of the rule or if a nurse is having a conversation with a co- worker about a patient and she shares all the patients personal information. The companies covered include any organization or person that shares medical information electronically for purposes such as authorizing benefits or medical referrals. This can include health insurance plans, health care providers, such as doctors and dentists, and companies that...
Words: 1094 - Pages: 5
...technology now allows human service organizations to more efficiently keep track of high priority information on clients, costs, and regulations. Years ago this information was kept by hand in ledgers. Nowadays client numbers, costs, and regulations have increased astronomically. As such information technology is the only way to keep track. There are a plethora of IT solutions for human service organizations. Out of the box solutions typically contain applications that record physician orders and keep track of claims and medical record information. Modern day regulation sets are complex and the need to keep track of these is extremely important. A good example of a large and complex regulation set is the Health Insurance Portability and Accountability act (HIPAA) which was put into law in 1996 by president, Bill Clinton. HIPAA has multiple facets. However the most important is that it sets rules on how to properly communicate medical data. Individuals, groups, or organizations that need to transfer medical data must do so according to HIPAA rules. As such administrators of health service organizations as well as IT professionals must understand the rules (Information Technology Association of America, 2004). The two most important components of HIPAA are simplification and privacy. Simplification means that the underlying HIPAA system must be based on one computer language, no matter where it is installed. Privacy requires that human service organizations do everything...
Words: 1556 - Pages: 7
...Health Insurance Portability and Accountability Act (HIPPA) Privacy Rule Abstract As one of the regulations of the Health Insurance Portability and Accountability Act (HIPPA) of 1996, Public Law 104-191; the HIPPA Privacy Rule sets “the standards for privacy of individually identifiable health information” (Speers, Wilcox, & Brown 2004). Established by the U.S. Department of Health and Human Services (HHS) in 2002, this set of national standards deals with the use and disclosure of health information, in addition to the principles guiding patients’ rights over their health information; which includes the right to review, obtain a copy of their health records, and request corrections. The ultimate goal of the Privacy Rule is to protect the confidentiality of patients’ health information while enabling the use of this information for appropriate health care related purposes. Health Insurance Portability and Accountability Act (HIPPA) Privacy Rule The Privacy Rule contains standards that outline terms for the electronic exchange, use, and privacy protection of patients’ personally identifiable medical information; also referred to as protected health information (PHI). These standards apply to the following covered entities: health clearinghouses, health plans, and health providers who transmit health information in electronic form; (Hoffman & Podgurski, 2007). Health clearinghouses are businesses that are utilized to process PHI into...
Words: 620 - Pages: 3
...HCA 542A Mod 11:2011 8wk-online Final Paper October 10, 2011 HIPPA This paper will begin with a brief background and history on the Health Insurance Portability and Accountability Act (HIPAA). Following the background will be details about issues that are address within the Health Insurance Portability and Accountability Act. The purpose of this paper is to provide a foundation with providing some information about HIPAA. Background The Health Insurance Portability and Accountability Act (HIPAA) was enacted by Congress in 1996 in response to several issues facing health care coverage, privacy, security and fraud in the United States (ALL THINGS MEDICAL BILLING, 2011, para. 2). Before HIPAA, rules and regulations varied by state, there was no real consistency. Also, there was confusion as to which regulations were applicable and to whom. Did the rules apply in the states where the organization was doing business or where the organization was based? There was also no uniformity between state and federal requirements (ALL THINGS MEDICAL BILLING, 2011, para. 3). With regard to privacy, there were numerous uncoordinated federal acts which addressed privacy in some form. Prior to HIPAA, there was no standard authority for enforcement of fraud and abuse that applied to state and federal health care programs (ALL THINGS MEDICAL BILLING, 2011, para. 4). Congress recognized the increased use of electronic technology, the potential for...
Words: 2149 - Pages: 9
...critical health care regulatory issue in today’s world is The Privacy and Security Rule. The Privacy Rule, 45 CFR (Code of Federal Regulations) Part 160 and Subparts A and E of Part 164 govern the privacy of individually identifiable health information and the security of electronic individually identifiable health information. CFR 45 Part 160 is otherwise known as the Health Insurance Portability and Accountability Act (HIPAA) (U.S. Department of Health and Human Services, 2012). HIPAA enacted in 1996, outlines the conditions protected health information (PHI) may be used or released by covered entities or individuals. The Office for Civil Rights (OCR) of the Department of Health and Human Services (HHS) enforces the HIPAA Privacy Rule. The Privacy Rule, modified in 2002 and 2003, set standards for protecting the integrity and confidentiality of PHIs covered entities must follow. Medical organizations and their employees have a legal and ethical responsibility to protect patients’ medical privacy at all times. Health care facilities and employees who fail to implement effective privacy rules and regulations are subject to fines, accreditation problems, and possible suits from affected individuals. Facilities and government agencies are liable to HHS for fines but also the cost of creating and adhering to a corrective plan of action that includes reassessing, revising, and initiating compliance programs for their facility (U.S. Department of Health and Human Services, 2012)...
Words: 287 - Pages: 2
...HIPAA provides rights to patients over health information and limits who can see or receive health information. Patients or patient’s personal representation has rights to their own medical records; however do not have access to psychotherapy notes. HIPAA privacy rules limits on who can see your medical records. Any information pertaining conversations with medical staff, health insurance, billing information and health information is protected. For example, employers cannot see you medical records and can’t be shared; unless you give your employer, a written consent or authorization. If rights are being denied based on discrimination or a violation of HIPAA privacy or security rule occurs; a complaint can be filed. Therefore; HIPAA does affect medical records, but it also protects our health information. A complaint is filed; when a cover entity has violated health information either by privacy rights or violation of privacy rules or security rules. Any person can file the complaint. The complaint must be filed in writing either by paper or electronically. When emailing the complaint, a signature is not needed for consent forms or the complaint. An email represents the signature. The complaint must name the cover entity and description of the violation act of what you believed that was violated and what happened. The complaint must be filed within 180 days from the day the incident occurred. For an extension, you must show a good cause to the office of civil rights. A complaint...
Words: 930 - Pages: 4
...College – University of Phoenix Your Name:…………… HIPAA LAW PROFILE At present, the human service industry is undergoing fundamental changes due to the rapid implementation of information technology solutions. These changes are due to, the growing challenges of regulatory burdens, to reduce company costs, and increase in patient care or clients. Today, most businesses use information technology solutions that include programs such as, computerized order entry for physicians, electronic claims processing, and electronic medical records. The need for this new technology in the human service sector is tremendous. In order to be successful, all human service providers are subject to a regulatory framework, such as the Health Insurance Portability and Accountability Act (HIPAA) which was signed on 21st of August, 1996 by the U.S President Bill Clinton. In very basic terms, HIPAA has two primary components to which hospitals, health plans, and healthcare. Anyone who transmits health information electronically must be in full compliance with the HIPPA Law. Consequently, healthcare providers and IT solutions providers are responsible for understanding HIPPA rules and regulations (Information Technology Association of America, 2004). "Clearinghouses," and healthcare providers must conform: Administrative simplification, which calls for use of the same computer language industry-wide; Privacy protection, which requires healthcare providers to take reasonable measures to protect...
Words: 1599 - Pages: 7
...Health Insurance Portability and Accountability Act “HIPAA” Cheryl Pierce Murray State University HCA405 November 19, 2014 When you walk into a doctor’s office or other medical facility, you have the assumption and expectation that things discussed between you and your healthcare provider will remain confidential. You might even sign papers that contain information about how you wish for your information to be disclosed. What you might not know is that this is a result of a large and broad federal law that hasn’t always been present. In the past, patients were unable to have a clear understanding of what can and cannot be discussed after consultation with medical professionals. This led to withholding important information, which could hinder their treatment and recovery. Medical records were not always kept confidential prior to HIPAA being enacted and enforced, and with the rules now in place, patients now have an understanding that their health information will remain private. American society places a high value on individual rights, personal choice, and a private sphere protected from intrusion. Medical records can include some of the most intimate details about a person’s life. They document a patient’s physical and mental health, and can include information on social behaviors, personal relationships, and financial status (Gostin and Hodge, 2002). The shift of medical records from paper to electronic formats has increased the potential for individuals to access...
Words: 2516 - Pages: 11
...protecting patient health information also need to evolve to cover the ever changing technologic advances. The concerns of protecting patients’ private healthcare information have grown as the use of electronic medical records has become more prevalent throughout the industry. In the 1960s computers began being used for generalizing human behavior. A physician established the idea of the Electronic Medical Record (Srinivasan, 2013). Unfortunately, the usage of electronic medical records did not become more mainstream until two decades later. (Srinivasan, 2013). As the use of EMRs became more prevalent healthcare information technology has played a “pivotal role in improving healthcare quality, cost, effectiveness, and efficiency,” (Srinivasan, 2013). However, the use of healthcare information technology has brought up concerns about privacy and protection of patient health information. In 1996, the Health Information Privacy and Accountability Act also known as HIPAA was passed. This was the first federal law regulating the privacy of health information. HIPAA was “designed primarily to modernize the flow of health information” (Solove, 2013). While at this time medical records were still in paper form, it was clear that health records would become digital in the future. (Solove, 2013). In the early years of HIPAA there was much confusion and no civil enforcement actions were taken. The Department of Health and Human Services (HHS) proposed a privacy regulation that was...
Words: 1984 - Pages: 8
...HIPAA Privacy – Safe Guarding and Securing Patient Data HIPAA Privacy – Safe Guarding and Securing Patient Data Robert N. Reges DeVry University/ HSM 410 Professor Anthony LaBonte 12 December 2010 Abstract According to section 1.07 of the APA Publication Manual [ (Ame01) ], “An abstract is a brief, comprehensive summary of the contents of the article; it allows readers to survey the contents of an article quickly, and like a title, it enables abstracting and information services to index and retrieve articles” (p. 12). . HIPAA Privacy – Safe Guarding and Securing Patient Data It has been said time and time again that life was much less complicated at the turn of the 20th Century and this saying could not be truer when it comes to medicine. At the turn of the 1900’s there was a personal bond between the provider and the patient, between the provider and the community, and between citizens in the community. In small towns across the nation there was less of a sense of privacy & individualism and more emphasis on helping your neighbor; because of this medical privacy was not a concern. You cannot help your neighbor if you are not aware of their issues. If we fast forward to the year 2010 times have changed significantly; with the advent of technology the American culture has changed. Personal information is no longer just stored on paper in the doctor’s office, patient information is stored in vast computer banks and sold like stocks and bonds on...
Words: 3127 - Pages: 13
...effectiveness of the health care system, the health insurance portability and accountability Act of 1996 (HIPAA), law 104-191, enclosed administrative Simplification provisions that needed Department of Health and Human Services to adopt national standards for electronic health care transactions and code sets, distinctive health identifiers, and security. At the same time, Congress recognized that advances in electronic technology may erode the privacy of health data. Consequently, Congress incorporated into HIPAA provisions that mandated the adoption of Federal privacy protections for identifiable classifiable health data. HHS published a final Privacy rule Dec 2000 that was later modified in August 2002. This Rule set national standards for the protection of individually identifiable health data by three types of covered entities: health plans, health care clearinghouses, and health care providers who conduct the quality health care transactions electronically. Compliance with the Privacy Rule was needed as of April 14, 2003 (April 14, 2004, for little health plans). HHS published a final Security rule in 2003. This Rule sets national standards for safeguarding the confidentiality, integrity, and availability of electronic protected health data. Compliance with the protection Rule was needed as of Apr 20, 2005 (April 20, 2006 for little health plans). OCR administers and enforces the Privacy Rule and also the Security Rule. other HIPAA administrative Simplification Rules are administered...
Words: 424 - Pages: 2
...THE HEALTH INSURACE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) Abstract This paper will explain what HIPAA is, a brief history and background of it; why it is so important, what are the rules, who is protected, who needs to follow the rules and who does not, who can see the patent information, and what kind of right the patent has. In general, this paper will cover and the importance of HIPAA, and the impacts that have on consumers and providers. This paper examines Mark A. Rothstein (2013) The Federal Register published the Department of Health and Human Services (HHS) omnibus amendments to the Health Insurance Portability Act (HIPAA) Privacy, security, Enforcement, and Breach Notification Keywords: HIPAA privacy and security of health care records. THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) Understanding HIPAA What is HIPAA? Department of health defined HIPAA as the federal Health insurance portability and accountability act. The objective is to make it easier for people to keep health insurance, protect the confidentiality and security of healthcare information and help the health care industry control administrative cost. HIPAA is written in 1996, enacted in April 14, 2001 and mandated in April 15, 2003. HIPAA is composed of two main rules; The HIPAA privacy rule and The HIPAA security rule. The HIPAA privacy rule provides for the privacy of individual’s personally identifiable health...
Words: 695 - Pages: 3
