Phase 3 Group Project Individual Submission


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What is HIPAA?

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  • Welcome to my Phase 3 Group Project Individual Submission!
  • Healing Hands Hospital has recently gained full reaccreditation with the Joint Commission. In an effort to promote this event, the assistant director of operations, Mr. William Wood has tasked the PR committee with promotion of not only the reaccreditation but the fact that Healing Hands Hospital is in full compliance with the Health Insurance Portability and Accountability Act of 1996, commonly referred to as HIPAA (Course Materials, 2009). This presentation will provide the PR committee with “additional information” needed for the campaign. An overview of HIPAA will be given, as well as the impact that the key aspects of portability and accountability have on our physicians and staff, as well as important concepts of the legislation that need to be understood. Examples of how this legislation affects Healing Hands hospital and staff in its role as provider also need to be expressed. In reviewing this information, a better understanding of the overall impact of HIPAA on Healing Hands Hospital will be realized.
  • The Health Insurance Portability and Accountability Act of 1996 was signed into law by President Bill Clinton (Shi & Singh, 2005). This legislation was enacted in response to a growing outcry for what was deemed a vast inequality in the healthcare industry regarding health insurance coverage and protection of vital personal health insurance information. HIPAA protects the nearly 25 million Americans who change employment, allowing them to “take their coverage with them”, as well as those Americans who are self-employed or have a pre-existing medical condition (Mondy, 2008). The law prohibits health insurance carriers from rejecting applicants based on a pre-existing medical condition, which in turn increases the number of Americans that may gain access to health insurance coverage (Mondy, 2008). The law also has provisions that enforce accountability of personal health information by protecting the privacy of individuals in setting regulations for release of such information (Mondy, 2008). This law has done much to close many gaps in the healthcare industry, and as a result, enhance the quality of life in terms of healthcare coverage for all Americans.
  • The portability provisions of HIPAA allow greater flexibility for all Americans in their efforts to gain medical insurance or keep medical insurance should they lose their jobs. In reality, this part of HIPAA address two key points- portability and nondiscrimination. While the concept of portability- i.e. being able to take one’s health insurance with them if they leave their place of employment is a noble concept at the outset, the reality of the matter is that it does not happen as much as one may think (Dranove, 2007). Healing Hands Hospital should address this topic from both the perspective of staff in accepting previous insurance or giving the option to drop previous insurance and accept our health plan, as well as accepting insurance from patients who find themselves in a similar situation. In terms of non-discrimination, this aspect may apply more to newly hired staff who may have preexisting medical conditions. In this event, Healing Hands should strive to find an acceptable private insurance carrier with a demonstrated compliance record in this regard (Barry & Grossmeier, 2009). Keeping in mind these two components ensures that we can tell the public with confidence, that at least in terms of this aspect of HIPAA, we are in compliance.
  • The other aspect of HIPAA concerns accountability, and this aspect has gained far more attention than portability. Specifically, it concerns protection of patient medical information and patient privacy in that regard (Mondy, 2008). As technology has improved, the health care industry has attempted to become more “user-friendly” in sharing information between providers in an effort to facilitate better communication and increased quality of healthcare. However, this on the surface may come into conflict with the patient security and privacy aspects of HIPAA (Ledford, HIPPA Compliance Gaps, 2007). In response, the healthcare industry has spent nearly $3.8 billion dollars to improve technological security as well as implementation of security and privacy standards to address these concerns, which according to estimates, will result in a realization of cost savings totaling $9 billion dollars annually (Ledford, Hitting the moving target of HIPAA requirements, 2002). The Federal government has also attempted to address this issue, with passage of the American Recovery and Reinvestment Act of 2009, which includes provisions to strengthen HIPAA in these key areas (Healthcare Risk Management, 2009). Since the trend toward an increased dependence on technology has significantly affected the way that patient medical records and patient privacy are addressed, implementation of these standards in terms of data encryption, “data restrictions, disclosure and reporting requirements” moves the industry closer to 100% compliance with HIPAA (Healthcare Risk Management, 2009). Such compliance is not only good for our hospital, but for our patients as well, reinforcing in their minds our commitment to their privacy.
  • Our PR committee must ensure that our claims of 100% compliance are accurate and verifiable. In conjunction with the human resources department, Healing Hands Hospital must ensure in terms of the first aspect of HIPAA, that portability of insurance and nondiscrimination are being followed. This can be expressed in terms of allowing employees who leave our facility to take their medical coverage with them if they wish, as well as offering new employees who are bringing in medical coverage to switch to our medical plan or keep their previous coverage. To this end, Healing Hands should ensure that any private medical insurance carrier we contract with to provide coverage is also compliant with the provisions of HIPAA as well. In terms of nondiscrimination, again we must ensure that for our staff, any pre-existing medical conditions are a non-issue in terms of coverage, thus again ensuring our claim of compliance is accurate. In terms of the other aspect of HIPAA, Healing Hands Hospital must ensure that we are technologically proficient to meet the litmus test of a secure patient records system, as well as ensuring that any data that is shared is shared with only those entities that are authorized to receive such information. Our standard operating procedures should be reviewed in comparison to HIPAA to ensure compliance, with frequent reviews for relevance and compliance. Finally, a comprehensive training program should be established and implemented to ensure that all staff are familiar with and in compliance with the provisions of HIPAA. Taking these steps will ensure again, that our claim of 100% compliance is a valid claim that can be backed up with documentation.
  • The Health Insurance Portability and Accountability Act of 1996 is one of the most significant pieces of legislation to ever affect the healthcare industry. It places at the center of its protection our most valued resources- our staff and our patients. Ensuring that our staff are afforded the flexibility to keep their medical coverage as well as ensuring that new staff are not victims of discrimination due to pre-existing medical conditions is important for their protection and peace of mind. Along those lines, the protection of our patient’s privacy and their medical records should be of paramount concern. Ensuring that our technological capabilities are able to meet the standard for protection brings us into compliance as well as putting our patient’s mind at ease. Making the effort to ensure our procedures and our staff training adequately address our compliance is also another priority. Taking these steps will establish Healing Hands Hospital as THE medical center of choice in this area of thought in the minds of our patients.
  • References.
  • References.
  • Phase 3 Group Project Individual Submission

    1. 1. Phase 3 Group ProjectIndividual Submission<br />Rick FindleyColorado Technical University OnlineThe Health Care IndustryHCM307-0903A-01<br />Julie Mathews, ProfessorDue: August 4, 2009<br />
    2. 2. Introduction<br />Healing Hands Hospital has recently gained reaccreditation by the Joint Commission.<br />Mr. Wood has tasked the PR committee with promoting this reaccreditation as well as our full compliance with HIPAA.<br />An overview of HIPAA including key aspects of the regulation will be reviewed.<br />Examples of how HIPAA affects Healing Hands Hospital and staff as a provider also will be reviewed.<br />
    3. 3. What is HIPAA?<br />The Health Insurance Portability and Accountability Act of 1996 was signed into law by President Bill Clinton.<br />HIPAA protects nearly 25 million Americans who<br />Change employment.<br />Are self-employed.<br />Have a pre-existing medical condition.<br />HIPAA prohibits health insurance carriers from rejecting coverage based on pre-existing medical conditions.<br />HIPAA also enforces accountability by enacting regulations protecting the privacy of personal health information.<br />
    4. 4. Portability<br />Portability addresses-<br />Portability in and of itself.<br />Nondiscrimination.<br />Portability itself equates to HHH-<br />Accepting medical coverage coming in.<br />Ensuring medical coverage going out.<br />HHH must also ensure new employees are not discriminated against due to pre-existing medical conditions.<br />
    5. 5. Accountability<br />This aspect of HIPAA receives predominantly more attention than portability.<br />Centers around protection of patient information and patient privacy.<br />Steps taken to improve technology-<br />$3.8 billion dollar cost.<br />$9 billion in cost savings.<br />American Recovery and Reinvestment Act of 2009 strengthens HIPAA by addressing technology issues.<br />
    6. 6. The Healing Hands Approach<br />Ensure 100% compliance with HIPAA by-<br />Ensuring portability.<br />Ensuring nondiscrimination.<br />Ensuring our technology is up to standard.<br />Ensuring our procedures are up to standard.<br />Ensuring a comprehensive training program is established and implemented.<br />Following these recommendations will support our claim of 100% compliance with HIPAA.<br />
    7. 7. Conclusion<br />HIPAA is one of the most significant pieces of legislation to affect the healthcare industry.<br />HIPAA places emphasis on protection of our most valued resources- our staff and our patients.<br />Compliance with HIPAA ensures peace of mind by<br />Ensuring portability.<br />Ensuring nondiscrimination<br />Ensuring protection of patient information and privacy.<br />
    8. 8. References<br />Barry, G., & Grossmeier, J. (2009, July). Is Your Incentive Strategy Sound? Guidelines for Designing a HIPAA Compliant Wellness Program. Retrieved July 26, 2009, from Associates Programs Source Plus database.<br />Course Materials. (2009). Retrieved July 25, 2009 from CTUO, Virtual Campus, HCM307-0903A-01: The Health Care Industry, Phase 3.<br />Dranove, D. (2007, October). Code Red- Insurance Portability. Retrieved July 26, 2009, from Kellogg School of Management web site:<br />Healthcare Risk Management. (2009, June). HIPAA compliance becoming even harder. Retrieved July 26, 2009, from CINAHL database.<br />
    9. 9. References<br />Ledford, J. (2007, March). HIPPA Compliance Gaps.Retrieved July 26, 2009, from Faulkner Security Management Practices database.<br />Ledford, J. (2002, October). Hitting the moving target of HIPAA requirements. Retrieved July 26, 2009, from Faulkner Security Management Practices database.<br />Mondy, R. (2008). Human resource management (10th Ed.).Upper Saddle River, NJ: Pearson-Prentice Hall. P. 329.<br />Shi, L., & Singh, D. (2005). Essentials of the US healthcare system. Sudbury, MA: Jones and Bartlett Publishers. P. 302.<br />