Welcometo

HIPAA Training

Presented by: Reginald AbadsantosDate: October 24, 2012Advisor: Dr. Susan Anderson

Learning Objectives

• Describe Health Insurance Portability and Accountability Act’s [HIPAA]– Purpose– Goals– Actions

• Identify Health Information Management Professionals’ Role

• Enumerate & Explain Privacy Rule’s– Elements– Who– What– How

• Evaluate Patient’s rights

• Purpose:• provide continuity of health coverage.• control fraud & abuse. • reduce healthcare cost. • guarantee the security & privacy of health information.

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• Goal:• greater individual rights with regards to a

person’s health information.• greater privacy protection of one's health

information

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HIPAA - Health Insurance Portability and Accountability Act of 1996

HIPAA - Health Insurance Portability and Accountability Act of 1996

What it does: limits exclusion for preexisting medical

conditions. prohibits discrimination against employees

and dependents based on health status. guarantees availability of health insurance

to small employers. guarantees renewability of insurance to all

employees regardless of size of employer.

HEALTH INFORMATION MANAGEMENT PROFESSIONALS

Health Information professionals are the custodians of patient information.

Role: protect the integrity and confidentiality of patient

information. assist in monitoring the healthcare facility’s

compliance with its own data security policies and procedures.

PRIVACY RULE a Federal law which gives

individual rights over their health information.

sets rules and limits on who can look at and receive your health information.

applies to all forms of individuals' protected health information, whether electronic, written, or oral.

entities covered by HIPAA is to ensure that electronic protected health information is secure.

KEY ELEMENTS OF PRIVACY RULE

Covered Entity

Uses and Disclosure

Compliance and Enforcement

Research

Individual Rights

Administrative Requirements

PRIVACY RULE – WHO IS TO FOLLOW THE RULE?

Note: HIPAA refer to them as covered entities

Health Plans

Most Health care Providers

Health care Clearing house

PRIVACY RULE – WHAT INFORMATION MUST BE PROTECTED?

Patient’s information entered by doctors, nurses and other healthcare providers.

Patient’s conversation with doctor about their care or treatment with nurses and others.

Information about patient in their health insurer’s computer system.

Billing information about patient. Most other health information about patient held by those

who must follow these laws.

PRIVACY RULE – HOW IS THE INFORMATION PROTECTED?

Covered entities must: have procedures in place to limit who can view

and access patient’s health information implement training programs for employees

about how to protect patient’s health information reasonably limit uses and disclosures to the

minimum necessary to accomplish their intended purpose.

PRIVACY RULE – HOW IS THE INFORMATION PROTECTED?

Covered entities must: put in place safeguards to protect patient’s

health information have contracts in place with their contractors

and others ensuring that they use and disclose patient’s health information properly and safeguard it appropriately.

PATIENT’S RIGHTS

Providers and health insurers must comply with patient’s right to:

Ask to see and get a copy of a their health records

Have corrections added to their health information.

Receive a notice that tells how their health information is used and shared.

PATIENT’S RIGHTS

Get a report on when and why patient's health information was shared.

Ask to be reached somewhere other than home. Ask that patient's information not be shared. File complaints.

Decide whether to give their permission before information can be used or shared for certain purposes

TRUE OR FALSEQUESTIONS

1. THE ROLE OF A HEALTH INFORMATION PROFESSIONAL IS TO ASSIST PATIENT IN FILING OUT THEIR HEALTH INFORMATION.

2. PRIVACY RULE ONLY APPLIES TO PROTECTING THE WRITTEN HEALTH INFORMATION OF AN INDIVIDUAL.

3. THE GOAL OF HIPAA IS TO PROVIDE GREATER PRIVACY PROTECTION OF AN INDIVIDUAL'S HEALTH RECORD.

4. ONE OF THE KEY ELEMENTS OF PRIVACY RULE IS STRUCTURE INTEGRITY.

5. HIPAA WAS SIGNED TO LAW IN 1996.

TRUE OR FALSEANSWERS

1. FALSE

2. FALSE

3. TRUE

4. FALSE

5. TRUE

TRUE OR FALSEQUESTIONS

6. HIPAA GUARANTEES AVAILABILITY OF HEALTH INSURANCE TO SMALL EMPLOYERS.

7. ONE OF THE PATIENT'S RIGHTS IS THE RIGHT TO BE ABLE TO ASK TO GET A COPY OF THEIR SPOUSE'S MEDICAL RECORD.

8. A PATIENT HAS TO THE RIGHT TO OPT OUT IN SHARING THEIR INFORMATION.

9. HIPAA REFERS TO HEALTHCARE PROFESSIONALS AS COVERED ENTITIES.10. BEFORE I WENT BACK TO MY POSITION, I HAD THE ABILITY TO ASK QUESTIONS ABOUT HIPAA PRIVACY PRACTICES.

TRUE OR FALSEANSWERS

6. TRUE

7. FALSE

8. TRUE

9. TRUE

10. TRUE

Summary• HIPAA Primary goal

– Making health care delivery more efficient and increasing the number of Americans health insurance coverage

• Value of HIPAA Privacy rule– Protecting patients personal privacy

• Articulate patient’s rights based on HIPAA Privacy practices

References:Health Information Privacy (n.d.). U.S. Department of Health and Human Services. Retrieved from http://www.hhs.gov/ocr/privacy/hipaaJohns, M.L. (2011). Health information management technology: An applied approach. Chicago, IL: Ahima Press.Nass, S.J., Levit, L.A., & Gostin, L.O. (Eds.). (2009). Beyond the

HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research. Institute of Medicine. Washington, DC: The National Academies Press. [NCBI library version] Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK9578/