St. David’s South Austin Medical Center (the “Hospital”) has received a letter from John Craven, an attorney representing former Hospital patient Ramona Reeves. Mr. Craven states that the Hospital’s entering into a Settlement Agreement with GEICO Insurance Company after the Hospital’s receipt of Ms. Reeves’ “HIPPA (sic) Revocation/Cancellation of Prior Authorization” constituted a wrongful disclosure of her individually identifiable health information (“PHI”). You have asked us to evaluate whether the provision of billing information and/or entering into the settlement agreement with GEICO violated HIPAA. The answer is no.
HIPAA is short for health insurance portability and accountability act of 1996. They have many requirement that’s a medical assistant could have and use to become a better assistant. They have many requirements that the policy requires covered encounters by taking reasonable steps: covered entry to develop and implement policies for its own organization. Reflecting the business practices and work force.
The purpose of the HIPAA transactions and code set standards is to simplify the processes and decrease the costs associated with payment for health care services. The transactions and code set standards apply to patient-identifiable health information transmitted electronically. Physician practices will continue to be able to submit paper claims. When the regulations take effect in October 2002, standard formats and code sets will take the place of any payer-specific or location-specific formats or requirements. ICD-9-CM Volume 1 and 2: Diagnosis Coding - ICD-9-CM is used to code and classify morbidity data from the inpatient and outpatient records, physician offices, and most National Center for Health Statistics (NCHS) surveys.
The federal Health Insurance Portability and Accountability Act also known as HIPAA has set a national standard for the handling of electronically stored medical records. Medical confidentiality protects conversations between a patient and his or her doctor from being used against the patient in court. It is a part of the rules of evidence in many common law jurisdictions. The penalties for violating HIPPA are based on the level of negligence and can range from $100 to $50,000 per violation or per record, with a maximum of $1.5 million per year. Violations can also carry criminal charges that can result in jail time.
I agree with you, Dr. Zhou should have clear understanding of the HIPAA law, that is part of orientation practice for everyone who has access to patient information in the health care field. For Dr. Zhou to access the patient electronic records after his termination is very alarming. Everyone agrees that his plea deal of $2000 of fine and four months in prison was a lesser punishment than what he deserves. According the HIPAA law he could spent more than 10 years in prison for his action .What is your thoughts. Don’t you think UCLA should have been liable for failing to protect the patient information.
Since HIPAA become mandatory on most of the health care organization, patient information is more secure compared to previous. Health care organization are investing huge amount of fund for safety measures to protect the patient information and i think this is the main concern in today's advanced health care
HIPAA is the acronym for the Health Insurance Portability and Accountability Act that was passed by Congress in 1996. the portion of HIPAA addressing the ability to retain health coverage is actually overseen by the California Department of Insurance and the California Department of Managed Health Care. The initial two titles of HIPPA are: Title I secures medical coverage scope for laborers and their families when they change or lose their employments. Second Title II known as the Administrative Simplification arrangements, requires the foundation of national measures for electronic human services exchanges and national identifiers for suppliers, medical coverage arrangements, and managers. HIPAA 's underlying object was to guarantee and enhance the coherence of medical coverage scope for laborers evolving employments.
The act is meant to followed by the rules, but the state can change certain thing according to the way it believes HIPAA should be done. If someone were to commit theft, he or she would have to pay thousand in fines and be sentenced to ten years of imprisonment. The hospitals and medical institutes must call, mail, email, or use the media to inform the victims that his or her information is a risk. They will have up to 30 days to contact everyone involved or an additional 30 if he or she is having trouble finding a large number of people or if the police have to become part of the solution.
Under HIPAA, covered entities are under the obligation to follow the rules and regulations that the law enforces (Cleverly). Healthcare providers, health plans, healthcare clearinghouses, and business associates of the listed covered entities face fines and discipline if there is a HIPAA violation (Cleverly). The use or cause to be used of a unique health identifier, obtaining individually identifiable health information relating to an individual, or disclosing individually identifiable health information to another person are all criminal offenses under the HIPAA act (Cleverly). The consequences of violating HIPAA are stiff and severe. The violations are as follows after a conviction: the person will be fined no more than $50,000,and imprisonment will not be more than a year; however, if the violation is committed under false pretenses, the fine is no more than $100,000, imprisonment is no more than five years, or both; and if the violation is done with intent to sell, transfer, or use individually identifiable health information, for personal gain, commercial advantage, or malicious harm, the fine cannot be more than $250,000, imprisonment no more than ten years, or both (Cleverly).
All healthcare professionals, whether it is the receptionists all the way up to the owner of the hospital, are going to have heard about HIPAA at some point in their employment. The punishment is pretty hefty, so that is probably why there are only a couple of cases with violations of HIPAA resulting in criminal severities. The legalities of breaching PHI “to a third party carries a jail term of up to 10 years in addition to a maximum fine of $500,000 if the disclosure is made
If you work in healthcare, anywhere from a small medical office to a big hospital to an insurance company, you need to be in compliance with HIPAA. This is a long, complicated document and even big insurance companies struggle to keep the rules fresh in everyone 's mind and everyone on top of the most critical functions. Here are a few things to make sure you are doing right: 1) Make sure Protected Health Information (PHI) is not casually observable. This means turning papers face down on your desk, not leaving charts visible on office doors, and making sure your computer screen cannot be readily seen by other people. This includes not only patients but other staff.
HIPAA is legislation that is mostly used in United States for the protection and privacy of the patient’s information. The medical information is protected by HIPAA whereby it ensures safe access to health and other personal information. HIPAA is therefore divided into five rules and regulations. There is private rule which ensures that all the information about individual’s health is highly protected. Private rule allows a good flow of health care information to ensure that an individual gets the best quality health care.
Nurses and doctors take the oath to protect the privacy and the confidentiality of patients. Patients and their medical conditions should not be discussed with anyone who is not treating the patient. Electronic health records are held to the same standards as nurses in that information is to be kept between, and shared only with the immediate care team. HIPAA violations are not taken lightly nor are the violation fines cheap. Depending on the violation, a hospital can be fined from $100 to $50,000 per violation (National Nurse 2011 p 23).
1. Locate an interesting article about a HIPAA violation in which a healthcare professional breached patient confidentiality. According to New York Times Article “New York –Presbyterian Hospital has agreed to pay a $2.2 million penalty to federal regulators for allowing television crews to film two patients without their consent- one which was dying, the other in significant distress. Regulators said on Thursday that the hospital allowed filming to continue even after a medical professional asked that it stop.” (Ornstein, 2016) a. Explain how HIPAA was violated
The goals of HIPAA are to ensure medical coverage scope for workers and their families when they change or lose their employments and to secure wellbeing information trustworthiness, classification, and accessibility. The objectives are also to enhance our health care framework by making it more proficient, less difficult, and less
