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Presented by Dr.Amandeep Singh Matharu MBA Hospital Management Roll No. - 14160
What is HIPAA and Why Should You Care.?
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The Health Insurance Portability and Accountability Act (HIPAA) is a law designed to improve the efficiency and effectiveness of the health care system. HIPAA directly affects clinical work and the operations of any facility. Understanding HIPAA prepares you to step into health organizations with a clear understanding of complying with requirements for respecting the privacy of protected health information (PHI).
BC . I will keep silence thereon. 4th century.HIPPOCRATIC OATH Whatsoever things I see or hear concerning the life of men. which ought not be noised abroad. Oath of Hippocrates. counting such things to be as sacred secrets. in my attendance on the sick or even apart therefrom.
To combat waste. HIPAA . To improve access to long term care services and coverage. and abuse in health insurance and health care delivery.• • • • • Health Insurance Portability and Accountability Act of 1996 (HIPAA) amended the Internal Revenue Code of 1986 To improve portability and continuity of health insurance coverage in the group and individual markets. To promote the use of medical savings accounts. fraud. To simplify the administration of health insurance. .The first federal law that governs the privacy of health information.
and patient information are safe from damage. • • • • . tampering. loss.CONFIDENTIALITY OF INFORMATION AND HIPAA PROVISIONS Any information communicated by a patient to a health care provider is privileged communication. PATIENTS HAVE RIGHT TO CONFIDENTIALITY HIPAA privacy and security provisions Right of privacy. Security safeguards to ensure that facilities. is private. equipment. theft or unauthorized access.
Administrative Simplification. and Medical Liability Reform Title III— Tax-Related Health Provisions Title IV— Application and Enforcement of Group Health Plan Requirements Title V— Revenue Offsets • • • • • .HIPAA LEGISLATIONS HIPAA legislation were organized according to five titles:Title I— Health Care Access. and Renewability Title II— Preventing Health Care Fraud and Abuse. Portability.
.name of employer.social security number (SSN).Medicaid ID number .date of birth.telephone numbers. . .address. .name.other medical record numbers. . . .PROTECTED HEALTH INFORMATION It is the information identifiable to an individual (or individual identifiers) .
HIPAA privacy standards protect the confidentiality of health information maintained or transmitted electronically. The rule mandates compliance by private and public sector organizations.HIPAA PRIVACY RULES • • • HIPAA provisions protect the security and confidentiality of health information. .
HIPAA PRIVACY RULES • • • • • • • • PATIENT RIGHTS Patient education on privacy protections Re Disclosure of PHI Patient access to their records Disclosures to business associates Patient care and notification Disclosures about deceased patients Limited uses and disclosures when the patient is not available Obtaining patient authorization before information is disclosed .
when violations of privacy protections occur. .Recourse if privacy protections are violated Patient's have the right to file a formal complaint with a covered entity.
2003.• • HIPAA SECURITY RULES HIPAA security rule was published on February 20. It adopts standards and safeguards to protect health information that is collected. or transmitted electronically. Physical Safeguards 3. maintained.used. Technical Safeguards . There are three categories of standards and specifications1. Administrative Safeguards 2.
An ongoing training program regarding the handling of PHI for employees. Internal audits play a key role in HIPAA compliance by reviewing operations. Organization should document instructions for addressing and responding to security breaches that are identified. Clearly identify employees who will have access to electronic protected health information (EPHI).. Organizations should ensure third party vendors comply with HIPAA requirements.• • • • • • • • ADMINISTRATIVE SAFEGUARDS Healthcare organizations must adopt a written set of privacy procedures. A contingency plan should be in place for responding to emergencies.Audits should be both routine and event-based. . Designate a privacy officer responsible for developing and implementing all policies and procedures.
Required access controls consist of facility security plans.PHYSICAL SAFEGUARDS • • • • • Controls must govern the introduction and removal of hardware and software from the network. Policies are required to address proper workstation use. maintenance records. and visitor sign-in and escorts. Access to hardware and software must be limited to properly authorized individuals. . Access to equipment containing health information should be carefully controlled and monitored.
Digital signature may be used to ensure data integrity. Healthcare organization must ensure that the data within its systems has not been changed or erased in an unauthorized manner.TECHNICAL SAFEGUARDS • • • • • • Information systems housing PHI must be protected from intrusion. Organizations must also authenticate entities with which they communicate. Documented risk analysis and risk management programs are required. Organizations must make documentation of their HIPAA practices available to the government to determine compliance. .
.SECURITY RULE PROVISIONS security provisions include following policies and procedures: • Define authorized users of patient information to control access • Implement a tracking procedure to sign out records to authorized personnel • Limit record storage access to authorized users • Lock record storage areas at all times • Require that the original medical record remain in the facility at all times.
chart-based research as well as to prospectively evaluate patients by contacting them for follow-up. Informed consent forms for research now include extensive detail which made already complex documents even less user-friendly for patients who are asked to read and sign them. lead physicians and medical centers to withhold information from those who have a right to it.EFFECT OF HIPAA ON RESEARCH AND CLINICAL CARE Effects on research • HIPAA restrictions have affected the ability to perform retrospective. . combined with potentially stiff penalties for violators. • Effects on clinical care • The complexity of HIPAA.
CLINICAL RESEARCH IS UNIQUELY AFFECTED BY HIPAA Specific methods to allow PHI to be used or disclosed for research purposes: All data are de-identified (according to the specific standards of the Privacy Rule). Special provisions are in place for research on a decedent’s PHI. A patient gives a written authorization that his or her data may be used and/or disclosed. • • • • • . Data are collected for preparatory work for research purposes only (according to the specific standards of the Privacy Rule). A limited data set is collected and released.
AUTHORIZATION TO DISCLOSE PHI Is Not Required • Public health activities • Law enforcement purposes • Judicial and administrative proceedings • Identification and location purposes • Decedents • Research purposes • Food & Drug Administration (FDA) • Specialized government functions. • Workers’ compensation .
• Government agencies.AUTHORIZATION TO DISCLOSE PHI Is Required • Attorney requests. • HIV-related information. • Health care providers that did not render care to the patient. . • Employers (except when PHI is released to report work-related illnesses or injuries).
except for the following:• Psychotherapy notes. • Information compiled for use in a civil. . • PHI maintained by a covered entity that is subject to the Clinical Laboratory Improvements.PATIENTS ACCESS TO RECORDS An individual has the right to access his or her own protected health information (PHI) for the purpose of inspection and to obtain a copy. criminal. or administrative action.
The Privacy Rule also recognizes that overheard communications in these settings may be unavoidable and allows for these incidental disclosures. Staff is free to communicate as required for quick.HIPPA rules are not a barrier to good care. effective. . and high-quality health care.! • • • The HIPAA Privacy Rule is not intended to prohibit providers from talking to each other and to their patients.
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