HIPAA Compliance Case Study

The Health Insurance Portability and Accountability Act (HIPAA), became law in 1996. It requires health care providers, insurance companies and others involved in health care transactions to provide security on any system containing personal health information, store and transmit that information according to standardized rules, and place an automatic audit on files to help keep track of who should have access to them and whether those access rules have been violated. HIPAA complaints and violations that aren't fixed quickly are subject to a fine of between $100 per incident or a maximum of $25,000 per year for violation of a specific rule.

Administrators at the University of Colorado found a way to comply HIPAA to protect the integrity of electronic patient records. In addition to meeting the Privacy requirement of HIPAA, they needed a system to deal with their staff of medical professionals who move from computer to computer throughout their shifts. To be better equipped to achieve compliance, the hospital chose to use technology via a
The Medicare Trust Fund received transfers of more than $1.51 billion during this period, and an additional $99 million in federal Medicaid money was similarly transferred to the Centers for Medicare and Medicaid Services (CMS). The HCFAC account has returned over $7.3 billion to the Medicare Trust Fund since the inception of the program in 1997" (Monetary results n.d, 2005).
There are many examples of Medicare fraud. Some include: incorrect reporting of diagnoses or procedures to maximize payment, billing for services not furnished, alteration of medical documentation, billing non covered services as covered. Punishment for fraudulent and abusive activity can range from provider education and a request for overpayment, to assessment of Civil Monetary Penalties of up to $10,000 per service billed and/or criminal