...Health Law and Regulations Overview This paper discusses the design of regulation agencies and the roles that they play in health care. There will also be a discussion on the current laws that health care face today, and an analysis on how these laws affect the hospital, clinic or insurer. This paper also includes how the population has little access to health care and an understanding of how HIPPA works and the role that it plays in the health care field. Healthcare The purpose of regulations is the constant need to balance the objectives of enhancing the quality, expanding access, and controlling costs in healthcare. Regulation plays a major role in the healthcare industry and healthcare insurance coverage. Through various regulatory bodies, the Department of Health and Human Services (HHS) protects the public from a number of health risks and provides programs for public health and welfare. Together, these regulatory agencies protect and regulate public health at every level ( Fierce Healthcare, 2014, para. 1). When it comes to health care there are many agencies that play a role in the management of the health care industry such as, Centers for Medicare and Medicaid (CMS) which deals with most of the regulations that deal directly to the healthcare system, they also “provides government subsidized medical coverage through a number of programs: Medicare, Medicaid, and State Children’s Health Insurance program (SCHIP)” (Fierce Healthcare, 2014, para. 2). Health...
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...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...
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..."Does the EMR actually protect patient privacy and what are the regulatory ramifications in the US on EMR implementation?” Table of Contents: INTRODUCTION LITERATURE REVIEW ANALYSIS I. MEDICAL RECORDS THEN AND NOW A. Paper-Based Medical Records VS. Electronic Medical Records B. Benefits, Potential Problems and Cost of the EMR II. HEALTH CARE PRIVACY LAW A. HIPAA 1.What is HIPAA? 2. HIPPA Privacy & Security B. HIPAA and EMR III. CAN ANYTHING BE DONE TO PROTECT PATIENT CONFIDENTIALITY/ PRIVACY? A. Why Should Patient Privacy Be Afforded Privacy Protection Regulation? B. Patient Privacy Within EMR IV. SPANNING THE MILES Intranet & Extranet Software & IM/IT CONCLUSION GLOSSARY REFERENCES Introduction: Healthcare companies all over the world are slowly recognizing the benefits on an EMR. Although EMR’s were implemented over 30 years ago but as of 2006 fewer than 10% of hospitals were utilizing the system. In 2009 the he U.S. Department of Health and Human Services enacted a privacy rule under the Health Insurance Portability and Accountability Act (HIPAA) in an attempt to protect the privacy of patients medical records. But one question still arises; “Does the EMR actually protect patient privacy and what are the regulatory ramifications in the US on EMR implementation?” In this paper I will address EMR, patient privacy and the regulatory ramifications of EMR implementation. Literature Review The literature shows that there is...
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...HSM 230 HSM Law Profile Paper Axia 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...
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...Regulatory and Compliance Issues Paper SANYUY D. ELVIS LAW 531 October 13, 2015 JAMES CHARNELL Regulatory and Compliance Issues Paper Do you think that the creation and work of the Public Company Accounting Oversight Board (PCAOB) has resulted in greater independence of auditors of public companies? Due to some major Corporate and Accounting Scandals in some prominent companies including Enron and WorldCom, Sarbanes–Oxley Act (SOX) was enacted in 2002. Through this, a lot of changes were introduced as to the regulation of Financial Practices and Corporate Governance. The SOX later on created the Public Company Accounting Oversight Board (PCAOB). The PCAOB is to oversee the audits of public companies and other issuers so that the interest of the investors can be protected and also further public interests in the preparation of Independent, accurate and informative audit reports. Therefore, all public companies are required to register with PCAOB and also follow its rules. Independence is one of the rules of the PCAOB. As stated in the PCAOB standards Section 101.01, “A member in public practice shall be independent in the performance of professional services as required by standards promulgated by bodies designated by Council”. Furthermore, according to the American Institute of Certified Public Accountants (AICPA), Independence can be defined as a state of mind that permits a member to perform an attest service without being affected by influences that can compromise...
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...Regulations Stephanie Sauceda HCS/545 March 17, 2014 Mary Cummings Health Law and Regulations Health care in the United States has changed over the years and the federal government saw need to establish regulatory agencies such as the Centers for Medicare & Medicaid Services (CMS) to ensure the elderly, disabled and low income receive quality and cost-effective health care. As a result of health care costs sharply increasing, the government determined it needed to have oversight on the health care industry and pushed for the establishment of managed care organizations (MCO). CMS enforces the Emergency Medical Treatment & Labor Act (EMTALA); this act was created to ensure health care organizations provide a minimum of a medical screening exam to determine if complaint is emergent or not. Most importantly for EMTALA is the obligation to treat emergent cases regardless of the patient’s ability to pay for services. In 1996, the Health Insurance Portability and Accountability Act (HIPAA) was approved by the United States Congress to regulate the use of and protect patient health records and the Department of Health & Human Services oversees the compliance and violations of HIPAA (Department of Health & Human Services, n.d.). The intentions of many of these regulatory agencies is to oversee that the health care industry is providing quality, affordable health care and treating patients with fairness and privacy. In 2008, the Centers for Medicare & Medicaid Services...
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...Administrative Ethics Paper Gwendolyn Matthews HCS/335 December19, 2011 Mr. Carmon Administrative Ethics Paper Privacy and confidentiality are important elements in the work of healthcare professionals. Ethical and legal issues may arise if providers fail to properly handle the protected health information of patients. The Health Insurance Portability and Accountability Act (HIPAA) of 1996 established guidelines for maintaining the privacy and confidentiality of patient data. The guidelines include the procedures that should be followed for the disposal of protected health information. This paper will be concerned with an article on the disposal of protected health information that was published in the June 1, 2011 issue of Managed Care Outlook. In the article, Niedzwiecki (2011) discusses the conditions under which it is appropriate to shred documents that contain protected health information. Niedzwiecki (2011) focuses on the problem of what should be done with paper originals after a patient’s private information has been placed in an electronic format. The basic solution to this problem is to shred sensitive paper documents before disposing of them. However, there is more to this issue, because some paper documents do not need to be disposed of and still others should not be disposed of. Therefore, as Niedzwiecki (2011) proposes, healthcare organizations should have a clearly stated policy regarding when documents should be shredded and when they should not be...
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...Compliance Regulations IT Governance 2/8/2015 Table of Contents Regulatory Compliance. Role of IT in Corporate Compliance. 3 Senior Management ignoring compliance mandates. Fines and Penalties 4 References 6 Regulatory Compliance. Role of IT in Corporate Compliance. Regulatory compliance intent is sometimes, to protect investors and their investments or how an industry-specific company handles private information. Also there regulations designed to provide transparency in the handling of the company´s finances and operations. Regulatory compliance also enforces ethical behavior, accountability, legal responsibilities and also penalties for companies and their senior management. The Gramm-Leach-Biley Act, or GLBA, also well known as the Financial Modernization Act of 1999 is an example of a federal law to control the way that financial institutions, institutions that exchange people´s financial information and “any institution that works with people´s money” (Chaple), manage private information of their consumers and customers. This act has different provisions relate to customers and consumer´s information: The Financial Privacy Rule and the Pretexting Provision are concern with the collection, access and disclosure of private financial information. The Safeguards Rule dictates that financial institutions must implement security programs to protect private information (In Brief: The Financial Privacy Requirements of the Gramm-Leach-Bliley Act...
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...The Health Information Technology for Economic and Clinical Health Act, better known as HITECH, is part of the American Recovery and Reinvestment Act of 2009. ARRA contains incentives related to health care information technology in general and The HIPAA Privacy Rule gives you rights over your own health information, regardless of its form. Whether your record is in paper or electronic form, you have the right to your records. HIPPA contains specific incentives designed to accelerate the adoption of HER systems among providers. The HIPPA act contains 5 different sections. Tite 1, the health insurance reform. Title I protect health insurance coverage for individuals who lose or change jobs. Title 2 is known as...
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...institutions either have both a hard copy and electronic medical record (EMR) of their patients, or just an EMR, which at times give patient data for studies excluding demographic information. That was not the case before July 2003 as medical facilities and providers were using all patient information and giving it to third-party agencies like pharmaceutical companies for profit, but now is unethical and illegal in accordance with the HIPAA Privacy Act. I’ll be presenting to the reder, what types of secondary sources exist, as well as the type of measurement scale will be used in order to prove if healthcare institutions’ ratings are partly based on how well the institutions themselves manage their information systems regulate ethical and legal management and use of patient data. Secondary Sources and Measurement Scale for Healthcare Ratings As Information Technology (IT) is widely used in almost every field, and making everyone’s jobs easier, and helping in maintaining records and history in compact form versus a few decades ago where it was mostly paper tracking and hard copies of documents, it has improved the way services are being rendered in the healthcare arena. In the medical field, IT is widely used throughout all departments from billing, laboratory results, x-rays, and Health Information Management (HIM, a term used for Medical Records Department). IT and its’ management not only is used in all fields, but has made our lives easier. Due to the many issues unethical...
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...Term Paper: Security Regulation Compliance Giancarlos Guerra Strayer University CIS 438 - Information Security Legal Issues Abstract: In this paper I shall provide an overview that will be delivered to senior management of regulatory requirements the agency needs to be aware of, including: i. FISMA; ii. Sarbanes-Oxley Act; iii. Gramm-Leach-Bliley Act; iv. PCI DSS; v. HIPAA; vi. Intellectual Property Law. Describe the security methods and controls that need to be implemented in order to ensure compliance with these standards and regulatory requirements. Describe the guidance provided by the Department of Health and Human Services, the National Institute of Standards and Technology (NIST), and other agencies for ensuring compliance with these standards and regulatory requirements. Term Paper: Security Regulation Compliance Introduction In the day-to-day operations of information security, security professionals often focus the majority of their time dealing with employee access issues, implementing security methods and measures, and other day-to-day tasks. They often neglect legal issues that affect information security. As a result, organizations often violate security-related regulations and often have to pay heavy fines for their non-compliance.” A Chief Information Officer in a government agency should realize the need to educate for senior leadership on some of the primary regulatory requirements, and realize the need to ensure that the employees in the agency...
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...Law and Regulations Federal regulations play a major role in the health care industry. Federal laws and regulations protect the American public from a number of health risks and administer programs for public welfare. Federal regulations also regulate the health insurance industry by implementing cost-containment measures. Through various regulatory bodies, Department of Health and Human Services (HHS) protects and regulates public health at every level. HHS is the United States principal federal agency for protecting the health of Americans and providing essential human services. HHS administers more grant dollars than all other federal agencies combined. Medicare program administered by HHS is nation’s largest health care insurance. HHS governs more than 300 programs administered by its 11 operating divisions (Department of Health & Human Services, 2011). In addition, Office of the Inspector General (OIG) is also part of the HHS. Description of each 300 programs is beyond the scope of this paper. However, it is imperative to understand the role of each operating agency and how it affects the health care industry. Role of Federal Regulatory Agencies Each operating division consists of sub-divisions making health care system a complex maze. Main 11 operating agencies are: Administration for Children and Families (ACF) The ACF provides funding for family assistance, child support, and childcare. The state, county, and city governments provide these services (Department of Health...
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...HIPAA Ruling in Tennessee Court Failure to adhere to regulatory compliance can impact a litigation process, which in the case of Stevens vs, Hickman Community Hospital was prominent when the Tennessee Court of Appeals dismissed the case based on failure to comply with Tennessee’s Medical Malpractice Act and the Health Insurance Portability and Accountability Act of 1996. This paper will include an IRAC Brief that will explain the case in detail followed by a brief explanation of governmental principles of regulatory compliance requirements, a brief explanation of methods for managing the legal risks that arise from regulatory compliance issues, and how this case can be applied within a business managerial setting. IRAC Brief Christine Stevens a Tennessee woman filed a malpractice lawsuit against Hickman Community Hospital, the emergency room services and physicians who cared for her husband Mark Stevens, which subsequently resulted in his demise. The case however is being challenged as a result of failing to comply with regulatory requirements set forth in the Tennessee Medical Malpractice Act and the Health Insurance Portability and Accountability Act of 1996. Case In accordance with the Tennessee Medical Malpractice Act, on April 11, 2011, counsel for Mrs. Christine Stevens the spouse of Steven Stevens, formally notified Hickman Community Hospital and Dr. Whitaker of the impending malpractice allegations...
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...Legal, Safety, and Regulatory Requirements Angelica Leadabrand HCS 341 September 26, 2011 Norman Greene Legal, Safety, and Regulatory Requirements In the healthcare industry there is a wide range of staff members who have a variety of specialties and responsibilities. Maintenance, Housekeeping, Medical staff, and Administration are all examples of positions available in hospitals or clinics. It is easy to see that staff in Administration may not have the same needs as staff members in Housekeeping. Healthcare organizations are regulated by different regulations that affect how patients are handled, paperwork is processes, and how chemicals are handled. Human Resources departments are responsible for how many of these regulations are addresses and followed. Failure to adhere to the many regulations placed upon healthcare organizations can result in costly fines and litigation. Some examples of regulations healthcare organizations are required to follow are Health Insurance Portability and Accountability Act of 1996 (HIPAA) (US Department of Health and Human Services, 2011) . HIPAA regulates how healthcare organizations protect the privacy of patients, access to medical records for patients and other healthcare organizations, and other aspects of insurance (US Department of Health and Human Services, 2011). Occupational Safety and Health Administration (OSHA) was enacted in 1970 (United States Department of Labor, 2011). OSHA regulates the work environment for staff...
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...Case Study, Stage 4: IT, Legal, Ethical and Regulatory Considerations for Proposed EHR Technology Solution Part 1 KAREO EHR is the proposed solution for UMUC family clinic. It’s benefits include being free for initial start-up, provides secure cloud-based technology and meets the highest standards for maintaining data confidentiality and secure sharing of information (Kareo, n/d). The recommended hardware for UMUC were 1 Desktop Macintosh: Intel or PowerPC G5 with 2GB or more of RAM, 3 iPad Air laptop for examination rooms, 5 Mbps or greater, Firefox 28 or higher on Mac OS X, Apple iOS 5/6 Communications will come from local phone and internet provider (e.g. Verizon or Comcast) both of the options provide high speed service. KAREO also offers Dr. Martin and his staff with a support staff for any issues pertaining to the program. It will also be vital that Dr. Martin, Vivian and Manuella are up to speed and trained equally on the hardware and software. With all member of this team being trained, it will ensure that it can improve the patient visit process currently at the clinic, in addition to the investment of patient check-in kiosk which can alleviate the 1-2 wait times also allowing the nurses to spend more time prepping rooms, attending to patients and less time at the front desk....
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