H = P = A = HIPAA DEFINED HIPAA … A Federal Law Created in 1996 Health

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Presentation transcript:

H = P = A = HIPAA DEFINED HIPAA … A Federal Law Created in 1996 Health Insurance Portability and Accountability Act H = I = P = A =

HIPAA PRIMER Definition Implications Sections Transactions Security Privacy HIPAA Compliance with Dell

Portability and Accountability Act (HIPAA) HIPAA OVERVIEW Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification [Accountability] ‘97 [Portability] Transactions, Code Sets, & Identifiers Compliance Date: 10/16/02 Or 10/16/03 Privacy Compliance Date: 4/14/03 Security Compliance Date: 4/15/05

HIPAA WHO IS AFFECTED? Etc... Providers Clearinghouses Hospitals Billing Agencies HIPAA Health Plans Pharmacies Laboratories Indirect Applicability: All organizations that exchange data with those directly covered under the HIPAA through Chain of Trust Agreements and/or contracts

IMPLICATIONS Loss of Accreditation (JCAHO, NCQA, etc.) Increased operating costs Imprisonment IMPLICATIONS FOR ORGANIZATIONS THAT DO NOT COMPLY Litigation damages Financial penalties Public exposure could lead to loss of market share Increased capital costs associated with “late” compliance efforts

PENALTIES Non-Compliance (Civil Penalty) $100 for each violation Maximum of $25,000 per year per incident Penalties up to $250,000 Unauthorized Disclosure or Misuse of Patient Information (Criminal Penalty) Penalties may apply to the individual violator but they may also apply to the organization or even to its officers

75-80% Policies & Procedures IMPACT OF HIPAA 20-25% Technical HIPAA = 75-80% Policies & Procedures 20-25% Technical 75-80% Policies & Procedures

TRANSACTIONS All entries must accept and return information in a designated standard electronic data interchange (EDI) format

What does the Privacy rule MEAN? Limits the Use and Disclosure of “Protected Health Information” -- PHI Establishes Patient’s right to control access and use of PHI

PRIVACY WHAT does the Privacy Rule MEAN? (cont’d) Balances health information protection and individual rights against public health and safety needs Administrative Requirements Privacy Officer Patient Notice Training for ALL employees Sanctions Documented Policies and Procedures

PRIVACY VS. SECURITY Privacy Security Refers to WHAT is protected – Health information about an individual and the determination of WHO is permitted to use, disclose, or access the information Security Refers to HOW private information is safeguarded – Ensuring privacy by controlling access to information and protecting it from inappropriate disclosure and accidental or intentional destruction or loss

SECURITY Purpose: Encompasses: To protect both the system and the information it contains from unauthorized access & misuse Purpose: All safeguards in a covered entity’s structure including: Information systems (hardware/software) Personnel policies Information practice policies Disaster preparedness Encompasses: