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Health Insurance Portability and Accountability Act of 1996 |
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- The most significant legislation to impact health care since the passage of the Medicare program of 1965;
- Designed to reinvent processes for paying health insurance claims.
- Legislation designed to reform the health insurance payment process
- The first-ever national standards to:
- Protect the privacy of patients' personal medical records;
- Reduce healthcare inefficiencies by simplifying and standardizing the use of information technology;
- Specify security processes for electronic health data.
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HIPAA COMPLIANCE TIMETABLE |
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- October 16, 2002
Code Set Requirements
- April 14, 2003
Large plan privacy requirement
- April 14, 2004
Small plan privacy requirements
- October, 2004
Tentative security requirement
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REASONS TO COMPLY |
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To avoid very large penalties and jail terms |
- Wrongful disclosure of private health information offense:
-Not more than $50,000 and/or imprisonment of up to one (1) year
- Offense under false pretenses:
-Not more than $100,000 and/or imprisonment of up to five (5) years
- Offense with intent to sell, transfer or use for commercial advantage, personal gain or malicious intent:
-Not more than $250,000 and/or imprisonment of up to ten (10) years
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WHAT NEEDS TO BE DONE? |
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- Develop a comprehensive set of standards and procedures to protect private health information;
- Make agreements with business partners to ensure that they have procedures in place to protect the information that they receive;
- Provide training to staff and business partners to ensure that they understand and can meet the requirements of the law. Set up information usage processes so that individuals can examine who has access to private health information;
- Allow individuals to examine their Private Health Information that is maintained and allow them to correct inaccuracies;
- Set up a reporting system for private health information that protects the information and reports to the Privacy Officer.
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Conclusions? |
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Protecting health data is important because it: |
- Increases individual access, comfort, and use of the medical system;
- Forces plan sponsors not to discriminate based upon health status;
- Is the law of the land and is backed up by significant fines and penalties
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FAQs about Portability of Health Coverage and HIPAA |
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Member Authorization |
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