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What is HIPAA? HIPAA: Health Insurance Portability and Accountability Act It was passed by Congress in 1996 It includes requirements for: Transfer and continuation of health insurance coverage for millions of American workers and their families when they change or lose their jobs Reducing healthcare fraud and waste Industry-wide standards for healthcare information on electronic billing and other processes The protection and confidential handling of protected health information Whom Does HIPAA Apply To? Applies to: Health Plans Healthcare Providers Healthcare Clearinghouses How is HIPAA Enforced? The Department of Health and Human Services, Office for Civil Rights (OCR) is responsible for administering and enforcing these standards and may conduct complaint investigations and compliance reviews. Violations can lead to civil money and criminal penalties Enforcement and Penalties –– New Definitions Reasonable Cause: An act or omission in which a covered entity or business associate knew, or by exercising reasonable diligence would have known, that the act or omission violated an administrative simplification provision, but in which the covered entity or business associate did not act with willful neglect. Reasonable Diligence: Business care and prudence expected from a person seeking to satisfy a legal requirement under similar circumstances. Willful Neglect: Conscious, intentional failure or reckless indifference to the obligation to comply with the administrative simplification provision violated. Criminal Penalties A person who knowingly obtains or discloses individually identifiable health information in violation of the Privacy Rule may face a criminal penalty of up to $50,000 and up to one-year imprisonment. For more details visit us at:http://www.complianceonline.com/the-new-hipaa-audit-program-focus-webinar-training-702335-prdw?channel=ppt-slideserve
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What is HIPAA? • HIPAA: Health Insurance Portability and Accountability Act • It was passed by Congress in 1996 • It includes requirements for: • Transfer and continuation of health insurance coverage for millions of American workers and their families when they change or lose their jobs • Reducing healthcare fraud and waste • Industry-wide standards for healthcare information on electronic billing and other processes • The protection and confidential handling of protected health information Whom Does HIPAA Apply To? Applies to: • Health Plans • Healthcare Providers • Healthcare Clearinghouses
How is HIPAA Enforced? • The Department of Health and Human Services, Office for Civil Rights (OCR) is responsible for administering and enforcing these standards and may conduct complaint investigations and compliance reviews. • Violations can lead to civil money and criminal penalties
Enforcement and Penalties –– New Definitions • Reasonable Cause: An act or omission in which a covered entity or business associate knew, or by exercising reasonable diligence would have known, that the act or omission violated an administrative simplification provision, but in which the covered entity or business associate did not act with willful neglect. • Reasonable Diligence: Business care and prudence expected from a person seeking to satisfy a legal requirement under similar circumstances. • Willful Neglect: Conscious, intentional failure or reckless indifference to the obligation to comply with the administrative simplification provision violated.
Criminal Penalties • A person who knowingly obtains or discloses individually identifiable health information in violation of the Privacy Rule may face a criminal penalty of up to $50,000 and up to one-year imprisonment. • The criminal penalties increase to $100,000 and up to five years imprisonment if the wrongful conduct involves false pretenses. • If the wrongful conduct involves the intent to sell, transfer, or use identifiable health information for commercial advantage, personal gain or malicious harm may face a fine up to $250,000 and up to 10 years imprisonment .
Want to learn more about HIPAA, its requirements and best practices to comply with them? ComplianceOnline webinars and seminars are a great training resource. Check out the following links: • How to examine security policies, practices, and risk issues to comply with HIPAA • How to use social media and texting without breaking HIPAA rules • How to Conduct risk analysis to comply with HIPAA • HIPAA/HITECH Assessment for Healthcare Business Associates • How to comply with HIPAA Omnibus Rule • Understanding new rules and responsibilities of Privacy Officer under HIPAA • HIPAA Security and Breach Rule Compliance
