Upload
gary-alexander
View
216
Download
1
Tags:
Embed Size (px)
Citation preview
Presented by Capture Billing and Consulting, Inc.Katie Jennings, RN and Michelle Ivanchukov, CPC, CCS-P
www.CaptureBilling.com703.327.1800
04/21/23 2
Health Insurance Portability and Accountability Act Health Insurance Portability and Accountability Act (HIPAA)(HIPAA)
04/21/23 3
Health Insurance Portability and Accountability Act Health Insurance Portability and Accountability Act (HIPAA)(HIPAA)
HIPAA Legislative ActHIPAA Legislative Act
HIPAA Public Law 104-191 is composed of the following:HIPAA Public Law 104-191 is composed of the following:
https://www.highmark.com/hmk2/about/hipaa/hipaaMain.shtml
04/21/23 4
Health Insurance Portability and Accountability Act Health Insurance Portability and Accountability Act (HIPAA)(HIPAA)
Administrative SimplificationAdministrative Simplification
04/21/23 5
Health Insurance Portability and Accountability Act Health Insurance Portability and Accountability Act (HIPAA)(HIPAA)
Administrative SimplificationAdministrative Simplification
These rules are enforced by the Office These rules are enforced by the Office for Civil Rights (OCR) of the HHSfor Civil Rights (OCR) of the HHS
04/21/23 6
Health Insurance Portability and Accountability Act Health Insurance Portability and Accountability Act (HIPAA)(HIPAA)
Covered EntitiesCovered Entities
04/21/23 7
Health Insurance Portability and Accountability Act Health Insurance Portability and Accountability Act (HIPAA)(HIPAA)
HIPAA Standards for Privacy of Individually Identifiable HIPAA Standards for Privacy of Individually Identifiable Health Information (Privacy Rule)Health Information (Privacy Rule)
04/21/23 8
Health Insurance Portability and Accountability Act Health Insurance Portability and Accountability Act (HIPAA)(HIPAA)
Protected Health Information (PHI)Protected Health Information (PHI)
04/21/23 9
Health Insurance Portability and Accountability Act Health Insurance Portability and Accountability Act (HIPAA)(HIPAA)
Use and Disclosure LimitationsUse and Disclosure Limitations
04/21/23 10
Health Insurance Portability and Accountability Act Health Insurance Portability and Accountability Act (HIPAA)(HIPAA)
Permitted UsePermitted Use
andand
DisclosureDisclosure
04/21/23 11
Health Insurance Portability and Accountability Act Health Insurance Portability and Accountability Act (HIPAA)(HIPAA)
Notice of Policy PracticesNotice of Policy Practices
Covered Entities must provide a notice of its Privacy Practices to include:
04/21/23 12
Health Insurance Portability and Accountability Act Health Insurance Portability and Accountability Act (HIPAA)(HIPAA)
Administrative RequirementsAdministrative Requirements
04/21/23 13
Health Insurance Portability and Accountability Act Health Insurance Portability and Accountability Act (HIPAA)(HIPAA)
De-identificationDe-identification
04/21/23 14
Health Insurance Portability and Accountability Act Health Insurance Portability and Accountability Act (HIPAA)(HIPAA)
Enforcement and ComplianceEnforcement and Compliance
Violations occurring on or after 2/18/2009:
Penalty Amount $100 to $50,000 or more per violation Calendar Year Cap of $1,500,000 Penalties may not be imposed in certain circumstances
• Failure to comply was not due to willful neglect and was corrected during a 30-day period after entity knew or should have known failure to comply occurred• Department of Justice has imposed a criminal penalty for failure to comply
04/21/23 15
Health Insurance Portability and Accountability Act Health Insurance Portability and Accountability Act (HIPAA)(HIPAA)
Criminal ProsecutionCriminal Prosecution
04/21/23 16
Health Insurance Portability and Accountability Act Health Insurance Portability and Accountability Act (HIPAA)(HIPAA)
HHS Case ExamplesHHS Case Examples
04/21/23 17
Health Insurance Portability and Accountability Act Health Insurance Portability and Accountability Act (HIPAA)(HIPAA)
HIPAA Violations Found on the web…HIPAA Violations Found on the web…
Nurses Fired Over Cell Phone Photos Of Patient
– Case Referred To FBI For Possible HIPAA Violations
Team 4 Uncovers HIPAA Records Violations
Cignet fined $4M for HIPAA violation Cignet Health of Prince George’s County has been fined a total of $4.3 million for alleged violations of the Health Insurance Portability and Accountability Act of 1996. The Department of Health and Human Services Office of Civil Rights alleges Cignet violated 41 patients’ rights in 2008 and 2009 by not providing them access to their medical records in a reasonable amount of time.
Two to plead guilty to fraud, HIPAA violations
UCLA Medical Center agrees to settle HIPAA violation charges for $865K
Local psychiatrist faces federal charges in HIPAA case
04/21/23 18
ReferencesReferences
Department of Health and Human Services:Department of Health and Human Services:http://www.hhs.gov/ocr/privacy/hipaa/understanding/index.html
Department of Medical Assistance Services:Department of Medical Assistance Services:http://www.dmas.virginia.gov/hpa-hipaa_faqs.htm
Highmark Blue Cross Blue Shield:Highmark Blue Cross Blue Shield:https://www.highmark.com/hmk2/about/hipaa/hipaaMain.shtml
Department of Labor:Department of Labor:http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html