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HIPAACompliancy Group2021-07-26T16:04:13-04:00 What is HIPAA Compliance?The Standards for Privacy of Individually Identifiable Health Information (Privacy Rule) sets forth, for the first time, a set of national standards for the protection of certain health information. What does HIPAA stand for? The U.S. Department of Health and Human Services (HHS) issued the HIPAA Privacy Rule to implement the requirement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The HIPAA Privacy Rule addresses the use and disclosure of individuals’ health information called “Protected Health Information (PHI)”. These types of organizations are called “covered entities”. The Privacy Rule HIPAA requirements outline for covered entities individuals’ privacy rights to understand and control how their health information is used. HHS and the Office for Civil Rights (OCR) have the responsibility for implementing and enforcing the HIPAA Privacy Rule with respect to compliance activities and civil money penalties. The HIPAA Privacy Rule is to assure that an individual’s health information is properly protected while allowing the individual’s necessary health information that is needed to provide and promote quality health care, is protected. The HIPAA Privacy Rule permits important uses of information, while protecting the privacy of people who seek healthcare. The HIPAA Privacy Rule is designed to be flexible and comprehensive to cover the variety of uses and disclosures that need to be addressed. Covered entities regulated by the Rule are required to comply with all of its applicable HIPAA requirements. The Privacy Rule applies to health plans, healthcare clearinghouses, and to any health care provider who transmits health information in any form in connection with transactions for which the Secretary of HHS has adopted standards under HIPAA (the “covered entities”). Health Care ProvidersEvery health care provider, regardless of size, who electronically transmits health information in connection with certain transactions, is a covered entity. These transactions include claims, benefit eligibility inquiries, referral authorization requests, or other transactions for which HHS has established requirements under the HIPAA Transactions Rule. Using electronic technology, such as email, does not mean a health care provider is a covered entity; the transmission must be in connection with a standard transaction. The HIPAA Privacy Rule covers a health care provider whether it electronically transmits these transactions directly or uses a billing service or other third party to do so on its behalf. Health care providers include all “providers of services” (e.g., institutional providers such as hospitals) and “providers of medical or health services” (e.g., non-institutional providers such as physicians, dentists and other practitioners) as defined by Medicare, and any other person or organization that furnishes, bills, or is paid for health care like a Health Care Clearinghouse. Business Associates and ContractsA business associate is a person or organization, other than a member of a covered entity’s workforce, that performs certain functions or activities on behalf of, or provides certain services to, a covered entity that involve the use or disclosure of individually identifiable health information. Business associate functions or activities on behalf of a covered entity include claims processing, data analysis, utilization review, and billing. Business associate services to a covered entity are limited to legal, actuarial, accounting, consultant, data aggregation, management, administrative, accreditation, or financial services. However, persons or organizations are not considered business associates if their functions or services do not involve the use or disclosure of protected health information, and where any access to protected health information by such persons would be incidental, if at all. A covered entity can be the business associate of another covered entity. Protected Health InformationThe HIPAA Privacy Rule protects and applies to all 18 fields of “individually identifiable health information” held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral. The Privacy Rule calls this information “protected health information (PHI). Individually identifiable health information” is information, including demographic data that relates to such personal information such as name, address, birth date, Social Security Number, address, past medical history etc. HIPAA requirements mandate that this type of information must be protected. Compliance DatesAll covered entities, except “small health plans,” were to be compliant with the HIPAA SECURITYWhat is the HIPAA Security Rule? The Security Rule requires covered entities to maintain reasonable and appropriate administrative, technical, and physical safeguards for protecting e-PHI. The Security Rule defines confidentiality to mean that e-PHI is not available or disclosed to unauthorized persons. The Security Rule’s confidentiality HIPAA requirements support the Privacy Rule’s prohibitions against improper uses and disclosures of PHI. Under the Security Rule, integrity means that e-PHI is not altered or destroyed in an unauthorized manner. Availability means that e-PHI is accessible and usable on demand by an authorized person. HHS recognizes that covered entities range from the smallest provider to the largest, so the Security Rule is flexible and scalable to allow covered entities to analyze their own needs and implement solutions appropriate for their specific environments. HIPAA Risk Analysis and Management• The Administrative Safeguards provisions in the Security Rule require covered entities to perform risk analysis as part of their security management processes. The risk analysis and management provisions of the Security Rule are addressed separately here because, by helping to determine which security measures are reasonable and appropriate for a particular covered entity, risk analysis affects the implementation of all of the safeguards contained
in the Security Rule. •Evaluate the likelihood and impact of potential risks to e-PHI; Risk analysis should be an ongoing process, in which a covered entity regularly reviews its records to track access to e-PHI and detect security incidents, periodically evaluates the effectiveness of security measures put in place, and regularly reevaluates potential risks to e-PHI. Administrative Safeguards• Security Management Process: A covered entity must identify and analyze potential risks to e-PHI, and it must implement security measures that reduce risks and vulnerabilities to a
reasonable and appropriate level. Physical Safeguards• Facility Access and Control: A covered entity must limit physical access to its facilities while ensuring that authorized access is allowed. Technical Safeguards• Access Control: A covered entity must implement technical policies and procedures that allow only authorized persons to access electronic protected health information (e-PHI). HIPAA Policies and Procedures and Documentation Requirements• A covered entity must adopt reasonable and appropriate policies and procedures to comply with the provisions of the Security Rule. A covered entity must maintain, until six
years after the later of the date of their creation or last effective date, written security policies and procedures and written records of required actions, activities or assessments. State Law• Preemption: In general, State laws that are contrary to the HIPAA regulations are preempted by the federal requirements, which means that the federal requirements will apply unless the state law is more stringent. Compliance Dates• Compliance Schedule: All covered entities, except “small health plans,” must have been compliant with the Security Rule. HIPAA Compliance SoftwareLearn How Simple Compliance Can BePage load linkImportant HIPAA Deadline: December 31st, Required Assessment Due Who is responsible for enforcing the HIPAA privacy and security rules quizlet?The Department of Health & Human Services (HHS) Office for Civil Rights (OCR) is responsible for enforcing the Privacy Rule and the Security Rule. Expanded HIPAA's security and privacy requirements to business associates, also subjecting them to civil and criminal penalties for violations of HIPAA.
What is the HIPAA officer quizlet?The HIPAA Privacy Officer is responsible for: Tracking who has access to PHI. The HIPAA Security Officers are responsible for: Safeguarding all electronic patient health information.
Who must comply with HIPAA quizlet?Healthcare providers (including doctors, nurses, hospitals, dentists, nursing homes, and pharmacies). As a healthcare worker, you are part of the "healthcare provider" network and therefore are required to comply with HIPAA rules and regulations regarding Protected Health Information (PHI).
What is true regarding HIPAA quizlet?What is true regarding HIPAA? protecting the patient information that is electronically stored and transmitted. This is the unique identifier given to all healthcare providers.
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