Examining the HIPAA
Examine the Federal Health Insurance Portability and Accountability Act. Discuss the history and purpose of HIPAA.
Identify concepts of privacy and security within the regulation and discuss methods that healthcare organizations must observe for compliance. Finally, discuss penalties for non-compliance with HIPAA
Be well organized using APA level headings to separate your topics
Include title page reference page for four to 6 pages total
Follow CSU global guide to writing and APA requirements
Examining the HIPAA Assignment Help
The HIPAA was passed on 21st August 1996 for the establishment of a national framework for promoting security standards and protecting health care data and information. HIPAA outlined various regulations that healthcare maintenance organizations, insurers and other health care plans, health care clearinghouses such as re-pricing companies and billing services, and health care providers must follow in the transmission of health information (HI) using the electronic platforms (Tovino, 2017; Nass, Levit, & Gostin, 2009). The emphasis on the compliance with the guidelines allows the protection of patient and health care data and information by demanding confidentiality and privacy. Most importantly, HIPAA was created to simplify and increase access to and use of health insurance in the quest to promote the health and wellbeing of the citizenry. Moreover, the Act focused on promoting cost-effectiveness in the healthcare industry by helping in controlling administrative costs (Nass, Levit, & Gostin, 2009). In examining HIPAA, the concepts of privacy and security, compliance, and penalties for non-compliance are clear.
The HIPAA portability, tax, and administrative simplification provisions (ASPs) enable the pursuance of the objectives of the Act. The portability provisions focus on protecting patients from losing health care coverage due to preexistent health conditions when changing their health plan following new employment. The provisions aim at reducing the number of self-employed or unemployed people without health insurance. According to Nass, Levit, and Gostin (2009), the HIPAA portability provisions were created to simplify the process of acquiring health insurance for unemployed and self-employed people without their employers. The implementation of HIPAA and the enforcement of the portability provisions have increased health insurance coverage. The tax provisions were designed and integrated into the regulation to offer similar benefits. Tovino (2017) and Nurse Aide-VIP (2016) states that HIPAA tax provisions were envisioned to make it easier for people to maintain insurance through the modification of the existing tax laws to enhance the affordability of health insurance. As Nass, Levit, and Gostin (2009) note, however, the Act utilizes tax breaks and incentives for the reduction of health care costs rather than regulating the price of health insurance.
The ASPs of HIPAA support the objectives of the Act. The provisions required the U.S. Secretary for the Department of Health to issue regulations regarding the electronic transmission of health data and information with specific emphasis on protecting the confidentiality of health consumers (Nass, Levit, & Gostin, 2009). The security standards, for instance, were issued for safeguarding electronic health care data/information. Additionally, the administrative simplification provisions included directions for the development of standards for unique health identifiers for employers, patients, providers, and health plans (Nurse Aide-VIP, 2016; Tovino, 2017). The unique identifiers are critical for the identification of the parties engaged in standard health transactions. Most importantly, the provisions required the establishment of privacy standards for protecting medical information. The use of electronic technology in the management of HI opened platforms for the erosion of privacy. HIPAA considered this challenge and recommended the creation of the standards for promoting privacy and confidentiality. The Privacy Rule of the HIPAA supports the rights of users concerning their health information (Nass, Levit, & Gostin, 2009).
The Privacy Rule standards focus on ensuring the protection of individuals’ HI while allowing the effective flow of the information for the provision and promotion of high-quality care. As the government emphasizes the protection of public health and wellbeing, the consideration of the rights of health consumers is critical. The provisions of the Act ensure that the users’ rights to privacy and the confidentiality of their health/medical information is protected (Nass, Levit, & Gostin, 2009). The privacy rule supports the management of the medical information without infringing on the rights of the users especially with the increasing adoption and implementation of electronic HI management and transmission. Tovino (2017) states that the Rule protects the privacy of the people seeking care and healing by demanding that access and use of patient information be limited to authorized persons. The flexibility of the provision ascertains effectiveness in the use or disclosure of information in a way that ensures the protection of users’ rights while allowing the provision of quality, effective, safe, and cost-effective care.
The privacy and security rule covers specific entities including the HMOs, health plans, health care providers (HCPs), and health care clearinghouse. HCPs include services such as preventive, therapeutic, diagnostic, palliative, rehabilitative, or maintenance care and assessment, counseling, or procedures with respect to mental or physical conditions, or the functional status of the consumer (Nurse Aide-VIP, 2016; Nass, Levit, & Gostin, 2009). Health plans include group or individuals pay the cost of care such as Medicaid and Medicare programs. Further, health care clearinghouses are businesses such as hospital and physician billing services that facilitate the processing of HI from other businesses. The entities are required by the law to comply with the Privacy Rule in accordance with the HIPAA. Compliance requires the implementation of measures that ensure the security of the HI for the promotion of the confidentiality and the privacy of the patients. The protection of personally identifiable information requires covered entities to safeguard the security of the information that;
“relates to past, present, or future physical or mental health or condition of an individual, the provision of health care to an individual, or the past, present, or future payment for the provision of health care for the individual, that either identifies the individual or with respect to which there is a reasonable basis to believe the information can be used to identify the individual” (Nass, Levit, & Gostin, 2009).
Compliance with HIPAA demands the creation and implementation of privacy policies, regular conduction risk assessments, and publication and distribution of privacy practices’ notice to patients. The process of developing and implementing the policy requires the entities to document the policies and procedures, appoint effective security and privacy officers, and assess risks to identify vulnerabilities and prevent security breaches or non-compliance with HIPAA. Additionally, according to Nass, Levit, and Gostin (2009), there is a need for organizations to train employees adequately on using and disclosing Protected HI. The training also keeps staff informed about new policies and procedures. Further, Herold and Beaver (2014) assert that there is a need for healthcare organizations to enter into valid business associate agreements and ensure proper implementation of privacy and security policies including taking the necessary measures against staff who violate the policies.
There are civil
and criminal penalties for non-compliance with HIPAA. When covered entities disregard
HIPAA and its privacy rule, the civil penalty includes $100 fine for every
violation occurring due to erroneous disclosure of information up to a maximum
of $25,000 in a year. The criminal penalty for individuals who disclose or
obtain Protected HI knowingly is a fine of up to $50,000 or one-year
imprisonment. Further, as outlined by the HIPAA, non-compliance committed under
pretenses attracts fines up to $100,000 and imprisonment of five years. Moreover, using or selling protected
information for personal gain, commercial use, or to cause harm results to ten
years imprisonment or a fine of up to $250,000 (Nass, Levit, & Gostin, 2009; Indiana University, 2017).
Herold, R., & Beaver, K. (2014). The practical guide to HIPAA privacy and security compliance, second edition. New York: CRC Press.
Indiana University. (2017, November 6). What are the penalties for violating HIPAA? Retrieved from Indiana University: https://kb.iu.edu/d/ayzf
Nass, S. J., Levit, L. A., & Gostin, L. O. (2009). Beyond the HIPAA privacy rule : enhancing privacy, improving health through research. Washington, D.C.: National Academies Press; Institute of Medicine (U.S.). Committee on Health Research and the Privacy of Health Information.
Nurse Aide-VIP. (2016). The HIPAA Privacy Rule: how to comply. Nurse Aide-VIP, 25(5), 3-14.
Tovino, S. A. (2017). The HIPAA Privacy Rule and the EU GDPR: Illustrative Comparisons. Seton Hall Law Review, 47(4), 973-993.