...Health Insurance Portability and Accountability Act Compliance Guide US Department of Health and Human Services Information Security Program Health Insurance Portability and Accountability Act (HIPAA) Compliance Guide September 14, 2005 Page i Health Insurance Portability and Accountability Act Compliance Guide US Department of Health and Human Services Table of Contents Table of Contents .......................................................................................... i Preface.........................................................................................................iii Document Change History ............................................................................iv 1. Introduction ....................................................................................... 1 1.1 1.2 1.3 1.4 2. 2.1 Purpose ........................................................................................... 1 Background...................................................................................... 1 Scope.............................................................................................. 2 Document Organization ..................................................................... 4 HIPAA Administrative Simplification Requirements ........................... 5 General Overview ............................................................................. 5 2.1.1 HIPAA Administrative Simplification Goals and Objectives ............. 5...
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...Health Insurance Portability and Accountability Act 1 Health Insurance Portability and Accountability Act Health Insurance Portability and Accountability Act of 1996 Other short title(s) Long title Kassebaum-Kennedy Act, Kennedy-Kassebaum Act An Act To amend the Internal Revenue Code of 1986 to improve portability and continuity of health insurance coverage in the group and individual markets, to combat waste, fraud, and abuse in health insurance and health care delivery, to promote the use of medical savings accounts, to improve access to long-term care services and coverage, to simplify the administration of health insurance, and for other purposes. HIPAA Colloquial acronym(s) Enacted by the 104th United States Congress Citations Public Law Stat. Pub.L. 104–191 110 Stat. 1936 [1] [2] Legislative history [3] • • • • • • • • • Introduced in the House as H.R. 3103 [4] by Bill Archer (D-TX) on March 18, 1996 [5] Committee consideration by: House Ways and Means Passed the House on March 28, 1996 (267–151 Passed the Senate on April 23, 1996 (100-0 [6] ) [7] ) [8] ) and by the Senate on , in lieu of S. 1028 Reported by the joint conference committee on July 31, 1996; agreed to by the House on August 1, 1996 (421–2 [9] August 2, 1996 (98–0 ) Signed into law by President Bill Clinton on August 21, 1996 e v t [10] The Health Insurance Portability and Accountability Act of 1996 (HIPAA; Pub.L. 104–191 [1], 110 Stat. 1936 [2] , enacted...
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...benefits is continuous log management policies. In addition to helping solve network security related issues, logs can be extremely beneficial in identifying unauthorized access and behaviors. Security logs assist in identifying policy violators, fraudulent behavior, real time operational problems, and provide necessary data to perform auditing, transaction back tracking and forensic analysis. In addition to the many benefits of having policies in place for continuous log analysis, standards and regulations have increased business awareness of the requirements for archiving and reviewing system logs as part of daily continuity. Some of the influential regulations that reference log management and other information security task include the following. • Federal Information Security Management Act of 2002 (FISMA) requires entities to ensure the development and execution of organizational processes and internal controls designed to secure information systems. Health Insurance Portability and Accountability Act of 1996 (HIPAA) encompasses information security benchmarks for protecting consumer health information. Violation Penalties can range from $100-$1.5 million per violation and 1year-10year criminal sentences. ISO 17799 is an audit checklist...
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...and the Health Insurance Portability and Accountability Act of 1996. This paper will include an IRAC Brief that will explain the case in detail followed by a brief explanation of governmental principles of regulatory compliance requirements, a brief explanation of methods for managing the legal risks that arise from regulatory compliance issues, and how this case can be applied within a business managerial setting. IRAC Brief Christine Stevens a Tennessee woman filed a malpractice lawsuit against Hickman Community Hospital, the emergency room services and physicians who cared for her husband Mark Stevens, which subsequently resulted in his demise. The case however is being challenged as a result of failing to comply with regulatory requirements set forth in the Tennessee Medical Malpractice Act and the Health Insurance Portability and Accountability Act of 1996. Case In accordance with the Tennessee Medical Malpractice Act, on April 11, 2011, counsel for Mrs. Christine Stevens the spouse of Steven Stevens, formally notified Hickman Community Hospital and Dr. Whitaker of the impending malpractice allegations in their care and treatment of Mark Stevens (FindLaw, 2013). The formal notice was also accompanied by a medical record release form allowing Mrs. Stevens legal counsel to obtain Mark Stevens medical records, however, the medical record request for was non complaint with the Health Insurance Portability...
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...External Environment and Government Policy Introduction The generic argument for governmental intervention is that the marketplace does not perform its normal function of optimizing resource production efficiency and resource allocation decision making as classical economics theory suggests. As a result of the market’s failure, government can, and some say should, intervene to fix the problem. However, some have argued that government interventions are designed to benefit those special interests that influence politicians rather than society as a whole (Austin & Boxerman, 2008). Discuss the impacts of breach to Healthcare Information systems, especially the financial and privacy impacts. Some of the most devastating security breaches can occur during employee termination when steps are not taken to remove access to resources in a timely manner. HIPAA guidelines specify that when employees are terminated, that certain steps, at a minimum, must be followed. These include changing locks, removal from access lists, removal of user account, and confiscation of keys, tokens and other access cards. Though these steps may seem to be common sense, some organizations may not have documented procedures to follow when an employee is terminated. Additionally, the responsibility for carrying out the termination procedures must be clearly assigned and documented (SANS Institute, 2001). Security Training In order for a security program to work well, the employees must be educated insecurity...
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...HIPAA: HIPAA is the acronym for Health Insurance Portability and Accountability Act that was passed in the ‘90s by congress that protects health coverage for workers and their family members when they change jobs. It also provides privacy to children ages 12-18 in that a provider must have written consent before disclosing any health information to anyone, including their parents. JCAHO: the Joint Commission on Accreditation of Healthcare Organizations is now known as The Joint Commission (TJC) and is a nonprofit organization that accredits health care organizations across the US. They review standards of care through surveyor visits and performance measures. Their mission is centered around providing safe, quality care. Organizations are surveyed every 3 years and are scored on compliance and non-compliance. Hospitals are required to meet TJC standards to receive reimbursements from Medicare and Medicaid and all information collected is visible to the public. Total Quality Management: TQM is one of the philosophies in continued process improvement. It’s a customer-focused tool that uses team members of an organization to collaborate using data and strategy to build process improvement into the everyday culture. TQM, very similar to lean manufacturing, drove an effort to focus on processes and problem solve from beginning to end for more streamlined, efficient and effective processes. Malcolm Baldridge award: The Baldridge award is an annual award given...
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...The Need for Information Security, Technical Innovation and Clinical Change. 1 The Need for Information Security, Technical Innovation and Clinical Change ISM 3011– Information Systems Management Abstract The Tri-County Life Care of the Treasure Coast (TLC) is a non-profit organization providing in-home health-care services throughout Florida's Indian River, Brevard, and northern St. Lucie Counties. TLC has been serving this community for over thirty years, but what truly makes us unique is our tradition of providing comprehensive health-care—whenever and wherever our patients need it. Tri-County Life Care, Inc. offers the highest quality and most reliable in home wellness care in the convenience and comfort of client home. (TLC) have been providing superior service to there clients and have help them in achieving their goals. Whatever your needs are, TLC home health team will design a plan that is specific to you and your situation. Whenever your health needs can be met at home, TLC staff is on-call 24 hours a day, 7 days a week. Owners and officers representing TLC are Chief Executive Officer - Eric Maar, Chief Financial Officer - Satchell Peterkin, Chief Technology Officer - Raquel Queen, and Chief Information Officer - Kerry Cosner. These individuals are committed to providing the clinical staff with the most technologically advanced tools available to effect patient care in the most advantageous way possible...
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...A1. Sentinel Event On the evening of September 14, 2011 a sentinel event occurred at Nightingale Hospital. According to Joint Commission, a sentinel event is characterized as an unexpected occurrence involving death or serious injury mother proceeded physical), or the risk thereof (http:www.jointcommission.org). A three year old child was accompanied by her mother for an outpatient procedure scheduled for September 1, 20111. The mother proceeded to register the child for the procedure and was provided details regarding anticipated length of surgical time and physical assessment. The pre-operative nurse was informed by the mother of the child that she needed to run an errand but left contact info(i.e. cellphone number) with the child’s nurse in the event the surgical procedure was to end sooner than expected. Unfortunately, the pre-operative nurse did not chart this pertinent information in the patients chart, it was documented on a sticky note attached to the chart. Post-surgery, the child was taken to the recovery area with care assumed by a recovery team without sight of mother. The father of the child presented to the recovery room and began hugging the child and was able to verify child’s name, date of birth, and was listed on face sheet in chart as father of the child with proper identification. Discharge instructions were provided to the father and the child was released in the fathers’ care. Approximately two and a half hours later, the mother arrived to the unit to...
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..."Does the EMR actually protect patient privacy and what are the regulatory ramifications in the US on EMR implementation?” Table of Contents: INTRODUCTION LITERATURE REVIEW ANALYSIS I. MEDICAL RECORDS THEN AND NOW A. Paper-Based Medical Records VS. Electronic Medical Records B. Benefits, Potential Problems and Cost of the EMR II. HEALTH CARE PRIVACY LAW A. HIPAA 1.What is HIPAA? 2. HIPPA Privacy & Security B. HIPAA and EMR III. CAN ANYTHING BE DONE TO PROTECT PATIENT CONFIDENTIALITY/ PRIVACY? A. Why Should Patient Privacy Be Afforded Privacy Protection Regulation? B. Patient Privacy Within EMR IV. SPANNING THE MILES Intranet & Extranet Software & IM/IT CONCLUSION GLOSSARY REFERENCES Introduction: Healthcare companies all over the world are slowly recognizing the benefits on an EMR. Although EMR’s were implemented over 30 years ago but as of 2006 fewer than 10% of hospitals were utilizing the system. In 2009 the he U.S. Department of Health and Human Services enacted a privacy rule under the Health Insurance Portability and Accountability Act (HIPAA) in an attempt to protect the privacy of patients medical records. But one question still arises; “Does the EMR actually protect patient privacy and what are the regulatory ramifications in the US on EMR implementation?” In this paper I will address EMR, patient privacy and the regulatory ramifications of EMR implementation. Literature Review The literature shows that there is...
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...Cleveland Clinic Children’s Hospital With the application of the Health Insurance Portability and Accountability Act (HIPAA) in the medical community, new issues arise for psychologists in keeping documented records of patient visits. Confidentiality limits have broadened, making use of the electronic medical record more complicated for the psychologist practitioner, particularly when serving as part of a multidisciplinary team. As the electronic medical record (EMR) has become more prevalent in multiple settings, various researchers have examined the effectiveness of this record keeping system, with a focus on improving patient outcomes. The risks and benefits of implementing an EMR will be discussed, focusing on specific considerations for psychologists in regard to confidentiality and interdisciplinary collaboration. Keywords: Health Insurance Portability and Accountability Act (HIPAA), electronic medical record (EMR), confidentiality How much information is appropriate to place in an electronic medical record (EMR), especially when that record is accessible to professionals throughout an organization (i.e., a hospital setting)? This question has become an important topic of discussion and research as EMRs become more prevalent in larger institutions, such as academic medical centers and community mental health centers. With the implementation of the Health Insurance Portability and Accountability Act (HIPAA), psychologists find themselves facing the struggle...
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...Database Security Challenges with Regards to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Paul T. MacDonald University of Maryland University College DBST670 Fall 2013 Professor Jon McKeeby Abstract With the expansion of healthcare administration now further into more levels of federal and state governments, the amount of sensitive patient data has increased incrementally This data is moved from within and without of all stages of the healthcare process. From an office visit to the doctor, to the medications filled at the local pharmacy, to the bills handled by multiple insurance agencies, delicate patient information is being viewed, handled and passed along. The list of individuals who access the confidential information can include office staff, laboratory personnel, nurses, doctors, insurance agents, case managers and many more. The Health/Insurance Portability and Accountability Act of 1996 (HIPAA) was created to safeguard patients’ medical data security and privacy. HIPAA incorporates requirements that allow for a comprehensive review that will show anyone who has looked at confidential medical patient information. HIPAA is structured to provide a complete security access and auditing for Oracle database information. This framework designates data access points such as User Access Control, System Administration, Object Access and Data Changes that should be monitored and controlled. An accurate HIPAA compliant security execution assures...
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...of the Health Insurance Portability and Accountability Act (HIPAA) in the United States (U.S.) and to discuss their objectives and purpose. To achieve this end, it is necessary to conduct a background analysis of the HIPAA breach notification rules. In addition, an evaluation of these rules will be highlighted. Moreover, the impact of the Final Omnibus Rule (FOR) of 2013 on breach notification rules will be emphasized. Finally, the way head will be underscored. Background In August 1996, President Bill Clinton signed HIPAA, which is the single most significant federal legislation affecting the U.S. health care industry since the creation of the Medicare and Medicaid programs in 1965. The five primary goals of the HIPAA legislation are: 1. To improve portability and continuity of health insurance coverage for individuals and groups. 2. To combat fraud, waste, and abuse in the health care industry. 3. To promote the use of medical savings accounts. 4. To improve access to long-term health care services and coverage. 5. To establish standards for administrative simplification (HIPAA, 1996). The Interim Final Rule for Breach Notification for Unsecured Protected Health Information, issued pursuant to the Health Information Technology for Economic and Clinical Health (HITECH) Act, which enacted as part of the American Recovery and Reinvestment Act (ARRA) of 2009, was published in the Federal Register on August 24, 2009 by the Department of Health and Human...
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...uphold the health care law”. The Affordable Healthcare Act affords new means to hold insurance companies responsible and offers strong selections for customers. For example as part of the recently upheld Affordable Care Act, all health insurers are required to spend a percentage of each premium dollar collected to pay claims and to provide clinical service and activities that improve health care quality. ("Healthcare.gov", 2012) The Medical Loss Ratio (MLR) is known as a percentage that healthcare insurers must meet or better known as the MLR requirement. Healthcare insurers are required by the Affordable Care Act to produce a reimbursement to its consumers. The Medical Loss Ratio financial measurement used in the Affordable Care Act to help ensure that health plans provide significant value to users. The following is an example of how insurers use the MLR According to "Healthcare.gov" (2012), “if an insurer uses 80 cents out of every premium dollar to pay its customers' medical claims and activities that improve the quality of care; the company has a medical loss ratio of 80%. A medical loss ratio of 80% indicates that the insurer is using the remaining 20 cents of each premium dollar to pay overhead expenses, such as marketing, profits, salaries, administrative costs, and agent commissions. The Affordable Care Act sets minimum medical loss ratios for different markets, as do some state laws” (Medical Loss Ratio). The Affordable Care Act Law forces payer insurance policies for...
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...Administrative Ethics Paper Introduction Advancements in health care technology have made it increasingly difficult for an organization to maintain the safety of patients’ medical records under the Health Insurance Portability and Accountability Act of 1996 (HIPPA) Privacy and Security Rules. Even after providing education to health care workers on proper HIPPA practices, there continues to be intended and unintended breaches especially in hospital settings. In 2010, New York-Presbyterian Hospital (NYP) and Columbia University (CU) health care system was under investigation for an accidental release of electronic medical records for 6,800 individuals. The incident impacted the health care industry because it was largest HIPPA settlement to date. At the time, U.S. News and World Reports NYP health care system as number one in the state and number six in the nation. The HIPPA Privacy Rule protects the “privacy of individually identifiable health information”; while the HIPPA Security Rule “sets national standard for the security of electronic protected health information”, and the HIPPA Breach Notification Rule requires business to notify of a “breach of unsecured protected health information” (HHS, 2014). Basically these rules are to protect the privacy of the patients’ health information. It says who can look at and receives information about the individuals. It gives the patients reassurance that their health information is safe and secure. The ethical and legal issues...
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...Analysis and Comparison of GLBA and HIPAA 1. Which US government agency acts as the legal enforcement entity for businesses and organizations involved in commerce? The Federal Trade Commission. 2. Which US government agency acts as the legal enforcement entity regarding HIPPA compliance and HIPPA violations? Office of Civil Rights(OCR) under the Department of Health and Human Services 3. List three (3) similarities between GLBA and HIPAA. 1. Safeguards Rules to protect customer information and consumer personal information. Security Rules 2. Protection of Privacy Rules from third party data sharing. 3. Protection of Financial Privacy Rules 4. List five (5) examples of privacy data elements for GLBA as defined in the privacy rule. 1.Safeguard Rules- protect customer information 2. Pretexting- protect consumers from individuals and companies that obtain their personal financial information under false pretenses. 3. Financial Privacy rules-governs the collection and disclosure of customers personal financial information by financial institutions. 4. Protection against credit reporting agencies 5. Protection from financial institutions that collect information from their own customers. 5. List five (5) examples of privacy data elements for HIPAA as defined in the privacy rule. a. Protection of Electronic Protected Health Information b. Covered entities must put in place secure electronic protection of health information. c....
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