Health Insurance Research Paper

HIPAA is Health Insurance Portability and Accountability Act. It is a federal act with guidelines for standardizing the electronic data interchange of administrative and financial transactions, exposing fraud and abuse, and protecting PHI. This law is designed to protect people’s private health information, to ensure health insurance coverage for workers and their families when they change or lose their jobs, uncover fraud and abuse, and create standards for electronic transmission of healthcare transactions. It contains five provisions called titles that focused on various aspects of healthcare. The titles are as follows:
Title I: Healthcare Access, Portability, and Renewability - Title I protects health insurance coverage for individuals
A covered entity is an organization that electronically transmits any information that is protected under HIPAA. Under HIPAA, three types of covered entities must follow the regulations: Health plans: the individual or group plan that provides or pays for medical care. Healthcare clearinghouses: companies that help providers handle such electronic transactions as submitting claims and that manage electronic medical record systems. Healthcare providers: people or organizations that furnish, bill, or are paid for healthcare in the normal course of
Which agency performs which task depends on the nature of the violation and is determined by the HIPAA Enforcement rule. Its purpose is to reconcile differences in enforcement procedures that had existed between the privacy and the security standards by imposing a single rule. It makes clear that both acts (things that are done) and omissions (things that are not done) like failure to implement a particular provision—may be HIPAA violations. Civil violations (those that are based on civil law, such as trespassing, divorce cases, and breach of contract proceedings) of the HIPAA privacy and security standards are enforced by the Office for Civil Rights (OCR), an agency of HHS. OCR has the authority to receive and investigate complaints as well as to issue subpoenas for evidence in cases it is investigating. If a person mistakenly obtained