HIPAA Privacy:HOW IT AFFECTS YOU !!!By: Brittany Koenig 1
Goals of Training• To increase your knowledge & understanding of what protected health information (PHI) is in this facility, and what threats may exist to its privacy and its security• To enhance your awareness of your role in helping this facility follow HIPAA rules• To provide information about to whom you can go with questions about privacy, and about security• To inform you about your reporting responsibilities when HIPAA violations occur• To alert you to the possible penalties for violation of HIPAA law for both you and this facility• To protect the confidentiality of our consumers Protected Health Information (PHI) in support of one of our values -- dignity, self-worth and individual rights. Its the right thing to do!• To Understand that this same law also protects you as a consumer of health care. 2
What is HIPAA?• Portability: Protects and guarantees health insurance coverage when an employee changes job• Accountability: Protects health data integrity, confidentiality and availability• Reduces Fraud and Abuse• Makes fraud prosecution easier (Medicare/Medicaid)• Reduces Paperwork 3
WHY COMPLY WITH HIPAA ?• Avoid denied and or delayed reimbursements – DHHS agencies process claims bringing in more than $ 550 million in receipts annually. – Annual Medicaid disbursements totaling more than $4.6 billion.• May risk Accreditation. (e.g. Joint Commission on Accreditation on HealthCare Organizations:• Public relations and business risk issues• Benefit from long term healthcare cost reductions• Impose severe penalties for non-compliance 4
DEFINITION: PRIVACYPrivacy is the right of an individual to keep his/her individual health information from being disclosed. 5
HIPAA Enforcement Continued• These penalties apply to oral, paper and electronic Protected Health Information (PHI). 6
QUESTIONS?• If you are ever in doubt, always ask your Supervisor or their designee!• Remember, that person is your first line of response to privacy questions. 7
ConclusionHIPAA - A Health Care Paradigm • Affects clearinghouses, patients. • Requires changes to business processes and applications, staffing plans, facilities and Information systems applications • Provides patients with rights • Shifts power in provider/consumer relationships • Introduces new legal liabilities • Conveys severe civil and criminal penalties payers, providers, employers, medical manufacturers, Pharmaceutical companies, employees 8
Conclusion Continued…HIPAA - is not going away• Healthcare industry wants standardization• Consumers want health information to be protected• HIPAA is not an option• HIPAA is doing business in the “New Millennium”• Implementation cost is short term• Operational benefit is long term 9
ReferencesUS Department of Health and Human Services - www.aspe.os.shhs.govCenter for Medicare and Medical Aid Services - www.cms/govWorkgroup for Electronic Data Interchange (WEDI) - www.wedi.orgWashington Publishing Company - www.wpc-edi.com 10
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