HIPAAHIPAAA Sea of Confusion, A Sea of Confusion,

A Wave of the future and A Wave of the future and A High Tide of ConfidentialityA High Tide of Confidentiality

Learning ObjectivesLearning Objectives• 1. Define HIPAA1. Define HIPAA• 2. State who is affected by HIPAA2. State who is affected by HIPAA• 3. Describe the changes for all 3. Describe the changes for all

health care professionalshealth care professionals• 4. Identify the components of 4. Identify the components of

protected health information.protected health information.

Learning ObjectivesLearning Objectives• 5. Discuss how HIPAA affects when a 5. Discuss how HIPAA affects when a

health care professional may disclose health care professional may disclose protected health information.protected health information.

• 6. State the penalties for wrongful 6. State the penalties for wrongful disclosure of protected health information.disclosure of protected health information.

• 7. Discuss patient rights as they relate to 7. Discuss patient rights as they relate to HIPAA.HIPAA.

What is it?What is it?• HIPAA, the Health Insurance Portability and HIPAA, the Health Insurance Portability and

Accountability Act of 1996 exerts its effects on Accountability Act of 1996 exerts its effects on the Health Care Industry with provisions that the Health Care Industry with provisions that encompass privacy, security and electronic encompass privacy, security and electronic transactions, standards for maintaining and transactions, standards for maintaining and transmitting protected health information.transmitting protected health information.

Why do I need to know about Why do I need to know about HIPAA?HIPAA?

• To learn how to provide for the To learn how to provide for the secure handling of protected health secure handling of protected health information in order to maintain information in order to maintain compliance with the regulationscompliance with the regulations

HIPAA Administrative HIPAA Administrative SimplificationSimplification• Electronic Transaction and Code Sets Electronic Transaction and Code Sets

Standards RequirementsStandards Requirements• Privacy requirementsPrivacy requirements• Security requirementsSecurity requirements• National Identifier requirementsNational Identifier requirements

Who is affected by HIPAAWho is affected by HIPAA• Health care providersHealth care providers

• Health PlansHealth Plans

• ClearinghousesClearinghouses

What is Protected Health What is Protected Health Information?Information?

• Any information that can identify a Any information that can identify a patientpatient

• Confidential health information and Confidential health information and demographicsdemographics

When can protected health When can protected health information be disclosed? information be disclosed? • necessary to accomplish intended necessary to accomplish intended

purposepurpose• Privacy rule applies to all informationPrivacy rule applies to all information• Routine disclosures of protected Routine disclosures of protected

health information need policies that health information need policies that identify eligible receivers of the identify eligible receivers of the information and the circumstancesinformation and the circumstances

What happens if HIPAA What happens if HIPAA required changes are not required changes are not made?made?

• Anyone who fails to comply with Anyone who fails to comply with regulations and make the required regulations and make the required changes faces serious consequenceschanges faces serious consequences

What happens if individually What happens if individually identifiable health information identifiable health information is wrongfully disclosed?is wrongfully disclosed?

• Monetary fines from $50,000 to Monetary fines from $50,000 to $250,000 depending on the scope $250,000 depending on the scope and severity of the violation and and severity of the violation and prison sentences of 1 to 10 yearsprison sentences of 1 to 10 years

What about patient rights What about patient rights under HIPAA?under HIPAA?• New rights to control their informationNew rights to control their information• Access, review and copy their Access, review and copy their

informationinformation• Ask for changes to their informationAsk for changes to their information• Describe how they want health providers Describe how they want health providers

and health plans to communicate with and health plans to communicate with themthem

• Included in maintenance, use and Included in maintenance, use and disclosure of their informationdisclosure of their information

SummarySummary• All health care providers are All health care providers are

mandated to comply with HIPAAmandated to comply with HIPAA• Major changes in the delivery of careMajor changes in the delivery of care• Greater security to keep information Greater security to keep information

privateprivate• Fines and imprisonment penalties for Fines and imprisonment penalties for

wrongful disclosurewrongful disclosure• Increased patient rightsIncreased patient rights

ReferencesReferences

• http://www.cms.hhs.gov/hipaa/http://www.cms.hhs.gov/hipaa/• https://hipaaprof.comhttps://hipaaprof.com• http://himinfo.com/newshttp://himinfo.com/news• http://aspe.hhs.gov/admnsimphttp://aspe.hhs.gov/admnsimp• http://aspe.hhs.gov/admnsimp/pl104http://aspe.hhs.gov/admnsimp/pl104

191.htm191.htm• www.discoveringhipaa.comwww.discoveringhipaa.com

Post TestPost TestTrue or FalseTrue or False

1.1. HIPAA affects only hospitals.HIPAA affects only hospitals.2.2. HIPAA means Health Insurance HIPAA means Health Insurance

Portability and Accountability Act.Portability and Accountability Act.3.3. Protected health information identifies a Protected health information identifies a

patient.patient.4.4. The privacy rule only applies to written The privacy rule only applies to written

information.information.5.5. The changes described by HIPAA are The changes described by HIPAA are

optional for health care facilities.optional for health care facilities.

Post TestPost TestUnder HIPAA, can this be done?Under HIPAA, can this be done?6. Ima Patient requests that a copy of 6. Ima Patient requests that a copy of

her medical record be faxed to her at her medical record be faxed to her at the local Kinko’s. the local Kinko’s.

7. Seymour Attorneys requests that his 7. Seymour Attorneys requests that his health care provider communicate health care provider communicate with him only through Federal Express with him only through Federal Express requiring his signature for receipt.requiring his signature for receipt.

Post TestPost TestMatch Column A with Column BMatch Column A with Column B

Column A Column A Column BColumn B

8.Health care provider8.Health care provider a. process a. process informationinformation

9.Health plan9.Health plan b. gives servicesb. gives services10.Clearinghouse10.Clearinghouse c. pays costsc. pays costs

This certificate is awarded to _______________________ for This certificate is awarded to _______________________ for completing a completing a

Basics of HIPAA seminar on __________________ at Basics of HIPAA seminar on __________________ at

______________________________________________

Presenter: _________________________Presenter: _________________________