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HIPAA OBJECTIVES Define HIPAA Define PHI Use of PHI Your rights Your responsibilities HIPAA H EALTH I NSURANCE P ORTABILITY and A CCOUNTABILITY A CT Components of HIPAA

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HIPAA OBJECTIVES

  • Define HIPAA

  • Define PHI

  • Use of PHI

  • Your rights

  • Your responsibilities


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HIPAA

  • HEALTH

  • INSURANCE

  • PORTABILITY and

  • ACCOUNTABILITY

  • ACT


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Components of HIPAA

  • Insurance portability – Insures individuals moving from one health plan to another will have continuity of coverage and will not be denied coverage under pre-existing-condition clauses.

  • Fraud enforcement (accountability) – Significantly increases the federal government’s fraud enforcement authority in many different areas.

  • Administration simplification – the most significant part of the legislation


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Easy to share.

Easy to misuse.


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  • Knowingly releasing patient information

    • 1 year jail sentence and $50,000 fine

  • Gaining access to health information under false pretences

    • five-year jail sentence and $100,000 fine

  • Releasing patient information with harmful intent or selling information

    • 10-year jail sentence and $250,000 fine


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Confidential = Identifiable Information

  • Names

  • Addresses

  • Employers

  • Relatives’ names

  • Dates of birth

  • Telephone and fax numbers

  • E-mail addresses


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Confidential = Identifiable Information Continued

  • Social Security numbers

  • Medical record numbers

  • Member or account numbers

  • Certificate numbers

  • Voice prints

  • Finger prints

  • Photos

  • Codes

  • Any other characteristic, such as occupation, which may identify individual

CONFIDENTIAL!


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PHI

  • Protected

  • Health

  • Information

PASSWORD


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Ways to Protect Patient Privacy

  • Do I need to know this to do my job?

  • Do not pass it on.


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Ways to Protect Patient Privacy

  • Close patient room doors to discuss treatments & administer procedures.

  • Close curtains & speak softly in semi-private rooms when discussing treatment & administering procedures.

  • Avoid discussions about patients in elevators & cafeteria lines.

  • Do not leave messages regarding conditions or test results on answering machines or with anyone other than patient.

  • Avoid paging patients using information that could reveal their health issues.


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Rules for Use

  • Treatment

  • Payment

  • Healthcare Operation

  • Authorization from individual patient

  • Disclose information to patient

  • Incidental disclosures are permitted


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Reasons to Release PHI Without Authorization

  • State health agencies require providers to report to them when patients have certain communicable diseases, even if patient doesn’t want it reported

  • The FDA requires providers to report certain information about medical devices that break or malfunction

  • Some states require physicians and other caregivers who suspect child abuse or domestic violence to report it to police


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Reasons Continued

  • Police have the right to request certain info about patients to determine whether they are suspects in criminal investigation or to assist in locating a missing person, material witness or suspect

  • Courts have the right to order providers to release patient information

  • Providers must report cases of suspicious deaths or suspected crime victims


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Privacy Rules Provide You As A Client New Rights

  • Notice of privacy

  • Right to restrict use & disclosure of PHI

  • Right to have PHI communicated by alternate means

  • Right to amend PHI

  • Accounting of disclosures of PHI

  • Right to access PHI


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Your Responsibilities

  • Understand PHI

  • Know rules

  • Know how to implement in your department

  • Reporting violations




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