How It Affects You!!!
Eilleen E. Ruidiaz
What is HIPAA?
Health Insurance Portability and Accountability Act of 1996 – a Federal Law * Portability * Administrative Simplification * Data Standardization * Security * Privacy
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)
* Data Standardization * Establishes National Standards for Electronic Data Transmission Portability * Transactions (Enrollment, Eligibility, Claims, Payment and others), Code sets and Identifiers. * Establishes Standards for Protection of Health Information * Privacy (Operational, Consumer Control, Administration)
Security (Administrative, Physical, Technical, Network)
Privacy is the right of an individual to keep his/her individual health information from being disclosed.
HIPAA KEY TERMS as they relate to privacy of Protected Health Information (PHI) * Privacy * Use * Disclose * Authorization * PHI * Minimum Necessary
HIPAA Enforcement * CIVIL PENALTIES for failure to comply * $100 fine per person per violation * $25,000 fine per year for multiple violations * $25,000 fine cap per year per requirement. * You can be personally liable!
CRIMINAL PENALTIES for failure to comply
Knowingly or wrongfully disclosing or receiving PHI: $50,000 fine and/or one year prison time
Commit offense under false pretenses: $100,000 fine and/or five years prison time
Intent to sell PHI or client lists for personal gain or malicious harm: $250,000 fine and/or ten years prison time.
Again, you can be personally liable!
These penalties apply to oral, paper and electronic Protected Health