HIPAA The Law Explained. Click here to view the HIPAA information.

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "HIPAA The Law Explained. Click here to view the HIPAA information."

Transcription

1 HIPAA The Law Explained Click here to view the HIPAA information.

2 HIPAA - Provisions 5 Major Provisions/Titles Title 1 Title 2 Title 3 Title 4 Title 5 More Information on Administrative Simplification and Insurance Reform

3 HIPAA Provisions Title 1 5 Major Provisions/Titles Title 1 Title 2 Title 3 Title 4 Title 5 Health Insurance Access, Portability, and Renewability HIPAA Title I deals with protecting health insurance coverage for people who lose or change their jobs More Information on Administrative Simplification and Insurance Reform

4 HIPAA Provisions Title 2 5 Major Provisions/Titles Click below to see a chart on covered entities. Title 1 Title 2 Title 3 Title 4 Title 5 Adobe Acrobat 7.0 Document Preventing Healthcare Fraud & Abuse, Administrative Simplification, & Medical Liability Reform HIPAA Title II includes an administrative simplification section which: 1. Deals with the standardization of healthcare related information systems; 2. Defines numerous offenses relating to health care and sets civil and criminal penalties for them. HIPAA Title II required the Department of Health and Human Services (DHHS) to establish and adopt national standards for electronic healthcare transactions. The national standards apply to the following Covered Entities : a. Healthcare Providers - Any provider of medical or other health services, or supplies, who transmits any health information in electronic form in connection with a transaction for which standard requirements have been adopted b. Health Plans - Any individual or group plan that provides or pays the cost of healthcare. c. Healthcare Clearing Houses - A public or private entity that transforms healthcare transactions from one form to another More Information on Administrative Simplification and Insurance Reform

5 HIPAA Provisions Title 3 5 Major Provisions/Titles Title 1 Title 2 Title 3 Title 4 Title 5 Tax-related Health Provisions Title III provides for certain deductions for medical insurance, and makes other changes to health insurance law. More Information on Administrative Simplification and Insurance Reform

6 HIPAA Provisions Title 4 5 Major Provisions/Titles Title 1 Title 2 Title 3 Title 4 Title 5 Application and Enforcement of Group Health Insurance Requirements Title IV specifies conditions for group health plans regarding coverage of persons with preexisting conditions, and modifies continuation of coverage requirements. More Information on Administrative Simplification and Insurance Reform

7 HIPAA Provisions Title 5 5 Major Provisions/Titles Title 1 Title 2 Title 3 Title 4 Title 5 Revenue Offsets Title V includes provisions related to companyowned life insurance, treatment of individuals who lose U.S. citizenship for income tax purposes and repeals the financial institution rule to interest allocation rules. More Information on Administrative Simplification and Insurance Reform

8 HIPAA Accountability & Portability Health Insurance Portability and Accountability Act (HIPAA) Click here for more info Click here for more info Administrative Simplification Accountability Insurance Reform Portability Transaction Code Sets, and Identifiers Compliance Date 10/16/03 Privacy Compliance Date 4/14/03 Security Compliance Date 4/26/05 Enforcement Compliance Date 3/16/06 Note: The Administrative Simplification sections of HIPAA are most relevant to health care providers while the Insurance Reform sections are most relevant to payers.

9 HIPAA Administration Simplification Electronic Transactions Privacy Security Enforcement Administrative Simplification consists of standards for the following areas: A. Electronic Transactions B. Privacy C. Security 1. Transactions 2. Code sets 3. Unique identifiers D. Enforcement Return to the Accountability & Portability Chart

10 HIPAA Administration Simplification Electronic Transactions Electronic Transactions Privacy Security Enforcement 1. Electronic transaction activities involve the transfer of electronic information for specific purposes. Electronic Data Interchange (EDI) is the leading media for electronic transactions 2. Code Sets are values that are used in the data fields to identify conditions, procedures and entities. Under HIPAA, local procedure codes were eliminated and replaced with National Standard Healthcare Common Procedure Coding System (HCPCS) is divided into two principal subsystems, referred to as level I and level II of the HCPCS. These are the code sets that have been selected as the National Standards and must be used consistently by covered entities. 3. Unique Identifiers - The Centers for Medicare and Medicaid Services (CMS) announced in January 2004, that it was adopting the National Provider Identifier (NPI) as the standard identification system for health care providers on their claim transactions. The NPI is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS) Return to the Accountability & Portability Chart

11 HIPAA Administration Simplification Privacy Electronic Transactions Privacy Security Enforcement The Privacy Rule took effect on April 14, 2003, with a one-year extension for certain "small plans." It established regulations for the use and disclosure of Protected Health Information (PHI). PHI is any information about health status, provision of health care, or payment for health care that can be linked to an individual. Return to the Accountability & Portability Chart

12 HIPAA Administration Simplification Security Electronic Transactions Privacy Security Enforcement The Final Rule on Security Standards was issued by DHHS on February 20, It took effect on April 21, 2003 with a compliance date of April 20, 2005 for most covered entities and April 20, 2006 for small plans. The Security Rule complements the Privacy Rule. While the Privacy Rule pertains to all Protected Health Information (PHI) including paper and electronic, the Security Rule deals specifically with Electronic Protected Health Information (EPHI). It lays out three types of security safeguards required for compliance: administrative, physical, and technical. 1. Administrative: policies and procedures designed to clearly show how the entity will comply with the act 2. Physical: controlling physical access to protect against inappropriate access to protected data 3. Technical: controlling access to computer systems and enabling covered entities to protect communications containing PHI transmitted electronically over open networks from being intercepted by anyone other than the intended recipient. Return to the Accountability & Portability Chart

13 HIPAA Administration Simplification Enforcement Point 1 Electronic Transactions Privacy Security Enforcement WHAT IS IT On February 16, 2006, DHHS issued the Final Rule regarding HIPAA enforcement. It became effective on March 16, The Enforcement Rule sets civil money penalties for violating HIPAA rules and establishes procedures for investigations and hearings for HIPAA violations, however deterrent effects have been negligible with few prosecutions for violations What is it Who s Responsible Fines Jail Time Return to the Accountability & Portability Chart Click here for more info rosoft Off D

14 HIPAA Administration Simplification Enforcement Point 2 Electronic Transactions Privacy Security Enforcement WHO'S RESPONSIBLE The DHHS Office for Civil Rights (OCR) is responsible for enforcing the HIPAA regulations. The reasoning is that the right of privacy of medical records is a fundamental civil right. In order to put more teeth into the civil penalties, the OCR enforces the civil side, and the DOJ enforces the criminal side. What is it Who s Responsible Fines Jail Time Return to the Accountability & Portability Chart

15 HIPAA Administration Simplification Enforcement Point 3 Electronic Transactions Privacy Security Enforcement Fines What is the civil penalty for failure to comply with HIPAA requirements and standards? a. Not more than $100 for each violation; and b. Not more than $25,000 for all violations of identical type during single calendar year What is it Who s Responsible Fines Jail Time Return to the Accountability & Portability Chart

16 HIPAA Administration Simplification Enforcement Point 4 Electronic Transactions Privacy Security Enforcement JAIL TIME Improperly obtaining or disclosing individual health information, or improper use of unique health identifiers are subject to the following penalties: Fine Prison Knowingly $50,000 1 Year What is it Who s Responsible Fines Jail Time False Pretenses $100,000 5 Years For Profit, Gain or Harm $250, Years Return to the Accountability & Portability Chart

17 HIPAA Portability The Insurance Reform section of HIPAA has changed the practices of health plans and insurers regarding PORTABILITY and CONTINUITY of health coverage in the following ways: 1. Provides limitations on pre-existing condition exclusions. 2. Prohibits discrimination against individuals based on health status. 3. Helps individuals to keep health insurance when they change jobs. 4. Prevents insurers from imposing pre-existing condition exclusions on new members when they have prior creditable coverage. 5. Guarantees that once employers or individuals purchase health insurance, those policies will be renewed. Return to the Accountability & Portability Chart

ü Ensuring the privacy and security of personally identifiable health information (the Privacy and Security Rules); and

ü Ensuring the privacy and security of personally identifiable health information (the Privacy and Security Rules); and Provided by Benefits By Choice HIPAA Rules: Privacy, Security and Electronic Data Interchange The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a broad federal law regarding health

More information

HIPAA Security Rule Compliance

HIPAA Security Rule Compliance HIPAA Security Rule Compliance Caryn Reiker MAXIS360 HIPAA Security Rule Compliance what is it and why you should be concerned about it Table of Contents About HIPAA... 2 Who Must Comply... 2 The HIPAA

More information

HIPAA Happenings in Hospital Systems. Donna J Brock, RHIT System HIM Audit & Privacy Coordinator

HIPAA Happenings in Hospital Systems. Donna J Brock, RHIT System HIM Audit & Privacy Coordinator HIPAA Happenings in Hospital Systems Donna J Brock, RHIT System HIM Audit & Privacy Coordinator HIPAA Health Insurance Portability and Accountability Act of 1996 Title 1 Title II Title III Title IV Title

More information

HIPAA: AN OVERVIEW September 2013

HIPAA: AN OVERVIEW September 2013 HIPAA: AN OVERVIEW September 2013 Introduction The Health Insurance Portability and Accountability Act of 1996, known as HIPAA, was enacted on August 21, 1996. The overall goal was to simplify and streamline

More information

HIPAA PRIVACY AND SECURITY AWARENESS

HIPAA PRIVACY AND SECURITY AWARENESS HIPAA PRIVACY AND SECURITY AWARENESS Introduction The Health Insurance Portability and Accountability Act (known as HIPAA) was enacted by Congress in 1996. HIPAA serves three main purposes: To protect

More information

ELECTRONIC HEALTH RECORDS

ELECTRONIC HEALTH RECORDS ELECTRONIC HEALTH RECORDS Understanding and Using Computerized Medical Records CHAPTER TEN LESSON ONE Privacy and Security of Health Records Understanding HIPAA HIPAA: acronym for Health Insurance Portability

More information

Understanding Health Insurance Portability Accountability Act AND HITECH. HIPAA s Privacy Rule

Understanding Health Insurance Portability Accountability Act AND HITECH. HIPAA s Privacy Rule Understanding Health Insurance Portability Accountability Act AND HITECH HIPAA s Privacy Rule 1 What Is HIPAA s Privacy Rule The privacy rule is a component of the Health Insurance Portability and Accountability

More information

HIPAA Overview. Health Insurance Portability and Accountability Act of 1996 (PL 104-191)

HIPAA Overview. Health Insurance Portability and Accountability Act of 1996 (PL 104-191) HIPAA Overview Health Insurance Portability and Accountability Act of 1996 (PL 104-191) Health Insurance Portability 1.Provides for insurance coverage to be portable as you move from job to job 2. Limits

More information

HIPAA OVERVIEW ETSU 1

HIPAA OVERVIEW ETSU 1 HIPAA OVERVIEW ETSU 1 What is HIPAA? Health Insurance Portability and Accountability Act. 2 PURPOSE - TITLE II ADMINISTRATIVE SIMPLIFICATION To increase the efficiency and effectiveness of the entire health

More information

HIPAA Overview. Darren Skyles, Partner McGinnis Lochridge. Darren S. Skyles dskyles@mcginnislaw.com

HIPAA Overview. Darren Skyles, Partner McGinnis Lochridge. Darren S. Skyles dskyles@mcginnislaw.com HIPAA Overview Darren Skyles, Partner McGinnis Lochridge HIPAA Health Insurance Portability and Accountability Act of 1996 Electronic transaction and code sets: Adopted standards for electronic transactions

More information

HIPAA Training 2010. For Research Investigators and Study Staff

HIPAA Training 2010. For Research Investigators and Study Staff HIPAA Training 2010 For Research Investigators and Study Staff HIPAA IS... THE HEALTH INSURANCE PORTABILITY & ACCOUNTABILITY ACT OF 1996 Portability Created to ensure access to health coverage Allows for

More information

Alert. Client PROSKAUER ROSE LLP. HIPAA Compliance Update: Employers, As Group Health Plan Sponsors, Will Be Affected By HIPAA Privacy Requirements

Alert. Client PROSKAUER ROSE LLP. HIPAA Compliance Update: Employers, As Group Health Plan Sponsors, Will Be Affected By HIPAA Privacy Requirements PROSKAUER ROSE LLP Client Alert HIPAA Compliance Update: Employers, As Group Health Plan Sponsors, Will Be Affected By HIPAA Privacy Requirements The U.S. Department of Health and Human Services published

More information

Health Insurance Portability and Accountability Act of 1996 (HIPAA) Contents

Health Insurance Portability and Accountability Act of 1996 (HIPAA) Contents Health Insurance Portability and Accountability Act of 1996 (HIPAA) Contents Health Insurance Portability and Accountability Act of 1996 (HIPAA)... 1 Welcome to HIPAA Awareness Training Content... 3 HIPAA

More information

#106 - HIPAA Regulations [1]

#106 - HIPAA Regulations [1] Published on Excellence In Learning (https://excellenceinlearning.net) Home > #106 - HIPAA Regulations #106 - HIPAA Regulations [1] $8.00 HIPAA Regulations Update 2 contact Hours Course # 106 Author: Monica

More information

What is HIPAA? The Health Insurance Portability and Accountability Act of 1996

What is HIPAA? The Health Insurance Portability and Accountability Act of 1996 What is HIPAA? The Health Insurance Portability and Accountability Act of 1996 BASIC QUESTIONS AND ANSWERS What Does HIPAA do? Creates national standards to protect individuals' medical records and other

More information

Healthcare Applications and HIPAA. BA590-IT Governance Final Term Project Prof. Mike Shaw

Healthcare Applications and HIPAA. BA590-IT Governance Final Term Project Prof. Mike Shaw Healthcare Applications and HIPAA BA590-IT Governance Final Term Project Prof. Mike Shaw Michael McIntosh 5/4/2007 Table of Contents 1. Abstract 3 2. Introduction 3 3. Section 1: HIPAA definition and history

More information

HIPAA Awareness Training

HIPAA Awareness Training New York State Office of Mental Health Bureau of Education and Workforce Development HIPAA Awareness Training This training material was prepared for internal use by the New York State Office of Mental

More information

Frequently Used Health Care Laws

Frequently Used Health Care Laws Frequently Used Health Care Laws In the following section, a select few of the frequently used health care laws will be briefly defined. Of the frequently used health care laws, there are some laws that

More information

HIPAA. HIPAA and Group Health Plans

HIPAA. HIPAA and Group Health Plans HIPAA HIPAA and Group Health Plans CareFirst BlueCross BlueShield is the business name of CareFirst of Maryland, Inc. and is an independent licensee of the Blue Cross and Blue Shield Association. Registered

More information

Why Lawyers? Why Now?

Why Lawyers? Why Now? TODAY S PRESENTERS Why Lawyers? Why Now? New HIPAA regulations go into effect September 23, 2013 Expands HIPAA safeguarding and breach liabilities for business associates (BAs) Lawyer is considered a business

More information

Welcome to the Privacy and Security PowerPoint presentation in the Data Analytics Toolkit. This presentation will provide introductory information

Welcome to the Privacy and Security PowerPoint presentation in the Data Analytics Toolkit. This presentation will provide introductory information Welcome to the Privacy and Security PowerPoint presentation in the Data Analytics Toolkit. This presentation will provide introductory information about HIPAA, the HITECH-HIPAA Omnibus Privacy Act, how

More information

HIPAA, HIPAA Hi-TECH and HIPAA Omnibus Rule

HIPAA, HIPAA Hi-TECH and HIPAA Omnibus Rule HIPAA, HIPAA Hi-TECH and HIPAA Omnibus Rule NYCR-245157 HIPPA, HIPAA HiTECH& the Omnibus Rule A. HIPAA IIHI and PHI Privacy & Security Rule Covered Entities and Business Associates B. HIPAA Hi-TECH Why

More information

HIPAA Enforcement Training for State Attorneys General

HIPAA Enforcement Training for State Attorneys General : State Attorneys General Enforcement of Federal Health Privacy Law HIPAA Enforcement Training for State Attorneys General Module Introduction : Introduction This module of the HIPAA Enforcement Training

More information

HIPAA Privacy at SCG...

HIPAA Privacy at SCG... HIPAA Privacy at SCG......What You Need to Know Click the Next arrow to view the next slide: Copyright 2003, Sarasota County Government All rights reserved Objectives: What Will I Learn? What is HIPAA?

More information

FINAL HIPAA HITECH REGULATIONS RELEASED

FINAL HIPAA HITECH REGULATIONS RELEASED FINAL HIPAA HITECH REGULATIONS RELEASED On January 25, 2013, the United States Department of Health and Human Services (HHS) published final regulations implementing changes to the Health Insurance Portability

More information

HIPAA Administrative Simplification and Privacy (AS&P) Frequently Asked Questions

HIPAA Administrative Simplification and Privacy (AS&P) Frequently Asked Questions HIPAA Administrative Simplification and Privacy (AS&P) Frequently Asked Questions ELECTRONIC TRANSACTIONS AND CODE SETS The following frequently asked questions and answers were developed to communicate

More information

Health Insurance Portability and Accountability Act HIPAA. Glossary of Common Terms

Health Insurance Portability and Accountability Act HIPAA. Glossary of Common Terms Health Insurance Portability and Accountability Act HIPAA Glossary of Common Terms Terms: HIPAA Definition*: PHCS Definition/Interpretation: Administrative Simplification HIPAA Subtitle F It is the purpose

More information

The HIPAA Privacy Rule: Overview and Impact

The HIPAA Privacy Rule: Overview and Impact The HIPAA Privacy Rule: Overview and Impact DISCLAIMER: This information is provided as is without any express or implied warranty. It is provided for educational purposes only and does not constitute

More information

University Healthcare Physicians Compliance and Privacy Policy

University Healthcare Physicians Compliance and Privacy Policy Page 1 of 11 POLICY University Healthcare Physicians (UHP) will enter into business associate agreements in compliance with the provisions of the Health Insurance Portability and Accountability Act of

More information

HIPAA Compliance and Varonis

HIPAA Compliance and Varonis HIPAA Compliance and Varonis HIPAA Compliance and Varonis About HIPAA Overview This document provides an overview of the Health Insurance Portability and Accountability Act (HIPAA), its scope and purpose

More information

HIPAA RISKS & STRATEGIES. Health Insurance Portability and Accountability Act of 1996

HIPAA RISKS & STRATEGIES. Health Insurance Portability and Accountability Act of 1996 HIPAA RISKS & STRATEGIES Health Insurance Portability and Accountability Act of 1996 REGULATORY BACKGROUND Health Information Portability and Accountability Act (HIPAA) was enacted on August 21, 1996 Title

More information

HIPAA (Health Insurance Portability and Accountability Act of 1996) Stetson University HIPAA Training

HIPAA (Health Insurance Portability and Accountability Act of 1996) Stetson University HIPAA Training HIPAA (Health Insurance Portability and Accountability Act of 1996) Stetson University HIPAA Training Objectives of this Training l To help you understand: l What HIPAA privacy rule is l Why it is important

More information

HIPAA Privacy Summary for Fully-insured Employer Groups

HIPAA Privacy Summary for Fully-insured Employer Groups HIPAA Privacy Summary for Fully-insured Employer Groups I. Overview The Privacy Regulations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulate the uses and disclosures

More information

HIPAA DATA SECURITY & PRIVACY COMPLIANCE

HIPAA DATA SECURITY & PRIVACY COMPLIANCE HIPAA DATA SECURITY & PRIVACY COMPLIANCE This paper explores how isheriff Cloud Security enables organizations to meet HIPAA compliance requirements with technology and real-time data identification. Learn

More information

Welcome to ChiroCare s Fourth Annual Fall Business Summit. October 3, 2013

Welcome to ChiroCare s Fourth Annual Fall Business Summit. October 3, 2013 Welcome to ChiroCare s Fourth Annual Fall Business Summit October 3, 2013 HIPAA Compliance Regulatory Overview & Implementation Tips for Providers Agenda Green packet Overview of general HIPAA terms and

More information

Pacific Medical Centers HIPAA Training for Residents, Fellows and Others

Pacific Medical Centers HIPAA Training for Residents, Fellows and Others Pacific Medical Centers HIPAA Training for Residents, Fellows and Others Summary of Critical Pacific Medical Centers (PMC) HIPAA Policies and Procedures For additional information or questions, please

More information

The Basics of HIPAA Privacy and Security and HITECH

The Basics of HIPAA Privacy and Security and HITECH The Basics of HIPAA Privacy and Security and HITECH Protecting Patient Privacy Disclaimer The content of this webinar is to introduce the principles associated with HIPAA and HITECH regulations and is

More information

HIPAA Privacy Summary for Self-insured Employer Groups

HIPAA Privacy Summary for Self-insured Employer Groups I. Overview HIPAA Privacy Summary for Self-insured Employer Groups The Privacy Regulations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulate the uses and disclosures of

More information

HIPAA and Privacy Policy Training

HIPAA and Privacy Policy Training HIPAA and Privacy Policy Training July 2015 1 This training addresses the requirements for maintaining the privacy of confidential information received from HFS and DHS (the Agencies). During this training

More information

HIPAA MANUAL. Most health plans and health care providers that are covered by the new Rule must comply with the new requirements by April 14, 2003.

HIPAA MANUAL. Most health plans and health care providers that are covered by the new Rule must comply with the new requirements by April 14, 2003. HIPAA MANUAL What is HIPAA? Health Insurance Portability and Accountability Act. The Health Insurance Portability and Accountability Act (HIPAA) provides rights and protections for participants and beneficiaries

More information

HIPAA Compliance. Saeed Rajput

HIPAA Compliance. Saeed Rajput HIPAA Compliance 1 What is HIPAA 26 cents of each health care dollar is spent on administrative overhead Health Insurance Portability & Account- ability Act - 1996 Public Law 104-191 191 To reform the

More information

Dissecting New HIPAA Rules and What Compliance Means For You

Dissecting New HIPAA Rules and What Compliance Means For You Dissecting New HIPAA Rules and What Compliance Means For You A White Paper by Cindy Phillips of CMIT Solutions and Kelly McClendon of CompliancePro Solutions TABLE OF CONTENTS Introduction 3 What Are the

More information

HealthStream Regulatory Script

HealthStream Regulatory Script HealthStream Regulatory Script HIPAA Release Date: August 2009 HLC Version: 602 Lesson 1: Introduction Lesson 2: HIPAA Overview Lesson 3: Transactions & Code Sets Lesson 4: Security Lesson 5: Unique Identifiers

More information

RONALD V. MCGUCKIN AND ASSOCIATES Post Office Box 2126 Bristol, Pennsylvania 19007 (215) 785-3400 (215) 785-3401 (Fax) childproviderlaw.

RONALD V. MCGUCKIN AND ASSOCIATES Post Office Box 2126 Bristol, Pennsylvania 19007 (215) 785-3400 (215) 785-3401 (Fax) childproviderlaw. RONALD V. MCGUCKIN AND ASSOCIATES Post Office Box 2126 Bristol, Pennsylvania 19007 (215) 785-3400 (215) 785-3401 (Fax) childproviderlaw.com HIPAA The Health Insurance Portability and Accountability Act

More information

HIPAA Orientation. Health Insurance Portability and Accountability Act

HIPAA Orientation. Health Insurance Portability and Accountability Act HIPAA Orientation Health Insurance Portability and Accountability Act HIPAA Federal legislation enacted in 1996 to improve the efficiency and effectiveness of electronic information transfers used in the

More information

Criminal Enforcement Under HIPAA: Covered Entities, DOJ and You. Presented by John N. Joseph April 24, 2006 HCCA Compliance Institute

Criminal Enforcement Under HIPAA: Covered Entities, DOJ and You. Presented by John N. Joseph April 24, 2006 HCCA Compliance Institute Criminal Enforcement Under HIPAA: Covered Entities, DOJ and You Presented by John N. Joseph April 24, 2006 HCCA Compliance Institute Wrongful Disclosure of Individually Identifiable Health Information

More information

Health Insurance Portability and Accountability Act (HIPAA)

Health Insurance Portability and Accountability Act (HIPAA) Health Insurance Portability and Accountability Act (HIPAA) General Education Presented by: Bureau of Personnel Department of Health Department of Human Services Department of Social Services Bureau of

More information

Compliance Training for Medicare Programs Version 1.0 2/22/2013

Compliance Training for Medicare Programs Version 1.0 2/22/2013 Compliance Training for Medicare Programs Version 1.0 2/22/2013 Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association. 1 The Compliance Program Setting standards

More information

Fraud, Waste and Abuse Training

Fraud, Waste and Abuse Training Fraud, Waste and Abuse Training 1 Why Do I Need Training? Every year millions of dollars are improperly spent because of fraud, waste and abuse. It affects everyone, Including YOU. This training will help

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT The parties to this ( Agreement ) are, a _New York_ corporation ( Business Associate ) and ( Client ) you, as a user of our on-line health record system (the "System"). BY

More information

HIPAA PRIVACY FOR EMPLOYERS A Comprehensive Introduction. HIPAA Privacy Regulations-General

HIPAA PRIVACY FOR EMPLOYERS A Comprehensive Introduction. HIPAA Privacy Regulations-General HIPAA PRIVACY FOR EMPLOYERS A Comprehensive Introduction HIPAA Privacy Regulations-General The final HIPAA Privacy regulation was released on December 20, 2000 and was effective for compliance on April

More information

OSF HEALTHCARE FALSE CLAIMS PREVENTION AND WHISTLEBLOWER PROTECTIONS

OSF HEALTHCARE FALSE CLAIMS PREVENTION AND WHISTLEBLOWER PROTECTIONS OSF HEALTHCARE FALSE CLAIMS PREVENTION AND WHISTLEBLOWER PROTECTIONS POLICY: CC-109 It is the policy of OSF HealthCare (OSF) that false, inaccurate or improper claims will not be submitted to any payer.

More information

ACRONYMS: HIPAA: Health Insurance Portability and Accountability Act PHI: Protected Health Information

ACRONYMS: HIPAA: Health Insurance Portability and Accountability Act PHI: Protected Health Information NAMI EASTSIDE - 13 POLICY: Privacy and Security of Protected Health Information (HIPAA Policies and Procedures) DATE APPROVED: Pending INTENT: (At present, none of the activities that NAMI Eastside provides

More information

Building Trust and Confidence in Healthcare Information. How TrustNet Helps

Building Trust and Confidence in Healthcare Information. How TrustNet Helps Building Trust and Confidence in Healthcare Information The management of healthcare information in the United States is regulated under the HIPAA (Health Insurance Portability and Accountability Act)

More information

3/13/2015 HIPAA/HITECH WHAT S YOUR COMPLIANCE STATUS? Daniel B. Mills Pretzel & Stouffer, Chartered WHAT IS HIPAA?

3/13/2015 HIPAA/HITECH WHAT S YOUR COMPLIANCE STATUS? Daniel B. Mills Pretzel & Stouffer, Chartered WHAT IS HIPAA? HIPAA/HITECH WHAT S YOUR COMPLIANCE STATUS? Daniel B. Mills Pretzel & Stouffer, Chartered WHAT IS HIPAA? 1 DEFINITIONS HIPAA Health Insurance Portability and Accountability Act of 1996 Primarily designed

More information

Patient Privacy and HIPAA/HITECH

Patient Privacy and HIPAA/HITECH Patient Privacy and HIPAA/HITECH What is HIPAA? Health Insurance Portability and Accountability Act of 1996 Implemented in 2003 Title II Administrative Simplification It s a federal law HIPAA is mandatory,

More information

Fraud, Waste, and Abuse

Fraud, Waste, and Abuse These training materials are divided into three topics to meet the responsibilities stated on the previous pages: Fraud, Waste, Compliance Program Standards of Conduct Although the information contained

More information

ROLE OF CONTRACT MANAGEMENT IN A HEALTHCARE COMPLIANCE PROGRAM DESIGN

ROLE OF CONTRACT MANAGEMENT IN A HEALTHCARE COMPLIANCE PROGRAM DESIGN ROLE OF CONTRACT MANAGEMENT IN A HEALTHCARE COMPLIANCE PROGRAM DESIGN John Riley Vice President of Sales MediTract, Inc. Session Overview Overview of Compliance Regulations affecting Contract Management

More information

Achieving HIPAA Security Rule Compliance with Lumension Solutions

Achieving HIPAA Security Rule Compliance with Lumension Solutions Achieving HIPAA Security Rule Compliance with Lumension Solutions Healthcare organizations face a host of HIPAA Security Rule compliance challenges with the move to put patient medical records online.

More information

Texas House Bill 300 & HIPAA. A MainNerve Whitepaper

Texas House Bill 300 & HIPAA. A MainNerve Whitepaper A MainNerve Whitepaper Overview If you do business in Texas and your organization handles, creates, stores, transmits or has access to electronic patient healthcare information, you need to be mindful

More information

12/19/2014. HIPAA More Important Than You Realize. Administrative Simplification Privacy Rule Security Rule

12/19/2014. HIPAA More Important Than You Realize. Administrative Simplification Privacy Rule Security Rule HIPAA More Important Than You Realize J. Ira Bedenbaugh Consulting Shareholder February 20, 2015 This material was used by Elliott Davis Decosimo during an oral presentation; it is not a complete record

More information

Joe Dylewski President, ATMP Solutions

Joe Dylewski President, ATMP Solutions Joe Dylewski President, ATMP Solutions Joe Dylewski President, ATMP Solutions Assistant Professor, Madonna University 20 Years, Technology and Application Implementation Experience Served as Michigan Healthcare

More information

HIPAA Privacy Regulations: Frequently Asked Questions

HIPAA Privacy Regulations: Frequently Asked Questions HIPAA Privacy Regulations: Frequently Asked Questions *** (Note: This information is from the national perspective. Health care facilities must comply with state privacy laws that may impose additional

More information

Penalty. Conduct of covered entity or business associate. Did not know and, by exercising reasonable diligence, would not have known of the violation

Penalty. Conduct of covered entity or business associate. Did not know and, by exercising reasonable diligence, would not have known of the violation WHY YOU NEED TO COMPLY. HIPAA UPDATE 2014: WHY AND HOW YOU MUS T C OMPL Y 1 In January 2013, the Department of Health and Human Services ( HHS ) issued its longawaited Omnibus Rule 2 implementing regulations

More information

EDUCATION ABOUT FALSE CLAIMS RECOVERY

EDUCATION ABOUT FALSE CLAIMS RECOVERY Type: MGI Corporate Policy Number: M 700 Effective Date: June 2014 Supersedes: AP 201, 4/12 Revised: 6/14 EDUCATION ABOUT FALSE CLAIMS RECOVERY I. PURPOSE This policy is intended to ensure compliance with

More information

Whitefish School District. PERSONNEL 5510 page 1 of 5 HIPAA

Whitefish School District. PERSONNEL 5510 page 1 of 5 HIPAA Whitefish School District R PERSONNEL 5510 page 1 of 5 HIPAA Note: (1) Any school district offering a group health care plan for its employees is affected by HIPAA. School districts offering health plans

More information

Frequently Asked Questions About the Privacy Rule Under HIPAA

Frequently Asked Questions About the Privacy Rule Under HIPAA Q-1: What is HIPAA? Frequently Asked Questions About the Privacy Rule Under HIPAA A: HIPAA is the Health Insurance Portability and Accountability Act (passed by Congress in 1996). The Privacy Rule was

More information

HIPAA Compliance, Notification & Enforcement After The HITECH Act. Presenter: Radha Chanderraj, Esq.

HIPAA Compliance, Notification & Enforcement After The HITECH Act. Presenter: Radha Chanderraj, Esq. HIPAA Compliance, Notification & Enforcement After The HITECH Act Presenter: Radha Chanderraj, Esq. Key Dates Publication date January 25, 2013 Effective date - March 26, 2013 Compliance date - September

More information

HIPAA Compliance Review

HIPAA Compliance Review HIPAA Compliance Review For HR and IT Presented by: Linda Railton, PHR HR Consultant Leavitt Group linda.railton@leavitt.com Discussion Points HIPAA Final Rule (effective March 26, 2013) Overview of HIPAA

More information

THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) EMPLOYEE TRAINING MANUAL

THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) EMPLOYEE TRAINING MANUAL THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) EMPLOYEE TRAINING MANUAL What is HIPAA? Comprehensive federal legislation regarding health insurance which is comprised of four key areas:

More information

HIPAA Privacy Keys to Success Updated January 2010

HIPAA Privacy Keys to Success Updated January 2010 HIPAA Privacy Keys to Success Updated January 2010 HIPAA Job Specific Education 1 HIPAA and Its Purpose What is HIPAA? Health Insurance Portability and Accountability Act of 1996 Title II Administrative

More information

Prepared by: The Office of Corporate Compliance & HIPAA Administration

Prepared by: The Office of Corporate Compliance & HIPAA Administration Gwinnett Health System s Annual Education 2014 Corporate Compliance: Our Commitment to Excellence Prepared by: The Office of Corporate Compliance & HIPAA Administration Objectives After completing this

More information

Fraud, Waste and Abuse Prevention and Education Policy

Fraud, Waste and Abuse Prevention and Education Policy Corporate Compliance Fraud, Waste and Abuse Prevention and Education Policy The Compliance Program at the Cortland Regional Medical Center (CRMC) demonstrates our commitment to uphold all federal and state

More information

HIPAA: Coverage and Implementation Issues (Focus on EDI and Privacy)

HIPAA: Coverage and Implementation Issues (Focus on EDI and Privacy) HIPAA: Coverage and Implementation Issues (Focus on EDI and Privacy) Robyn A. Meinhardt, RN, JD October 16, 2000 First National HIPAA Summit Washington, D.C. What This Presentation Will Address New Definitions

More information

HIPAA Security. 1 Security 101 for Covered Entities. Security Topics

HIPAA Security. 1 Security 101 for Covered Entities. Security Topics HIPAA SERIES Topics 1. 101 for Covered Entities 2. Standards - Administrative Safeguards 3. Standards - Physical Safeguards 4. Standards - Technical Safeguards 5. Standards - Organizational, Policies &

More information

The HIPAA Security Rule Primer Compliance Date: April 20, 2005

The HIPAA Security Rule Primer Compliance Date: April 20, 2005 AMERICAN PSYCHOLOGICAL ASSOCIATION PRACTICE ORGANIZATION Practice Working for You The HIPAA Security Rule Primer Compliance Date: April 20, 2005 Printer-friendly PDF 1 Contents Click on any title below

More information

AGREEMENT FOR ACCESS TO PROTECTED HEALTH INFORMATION BETWEEN WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER AND

AGREEMENT FOR ACCESS TO PROTECTED HEALTH INFORMATION BETWEEN WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER AND AGREEMENT FOR ACCESS TO PROTECTED HEALTH INFORMATION BETWEEN WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER AND THIS AGREEMENT for Access to Protected Health Information ( PHI ) ( Agreement ) is entered

More information

Standards of. Conduct. Important Phone Number for Reporting Violations

Standards of. Conduct. Important Phone Number for Reporting Violations Standards of Conduct It is the policy of Security Health Plan that all its business be conducted honestly, ethically, and with integrity. Security Health Plan s relationships with members, hospitals, clinics,

More information

HIPAA Compliance and PrintFleet Software Applications

HIPAA Compliance and PrintFleet Software Applications HIPAA Compliance and PrintFleet Software Applications PrintFleet Software Applications Do Not Impact HIPAA Compliance The use of PrintFleet software applications will not have an impact on compliance with

More information

An Employer s Introduction to HIPAA Prepared by Ballard, Rosenberg Golper & Savitt, LLP

An Employer s Introduction to HIPAA Prepared by Ballard, Rosenberg Golper & Savitt, LLP An Employer s Introduction to HIPAA Prepared by Ballard, Rosenberg Golper & Savitt, LLP Important Disclaimer: Practice limited to labor and employment law on behalf of management and related litigation.

More information

The following presentation was based on the

The following presentation was based on the Fraud Waste and Abuse Presentation The following presentation was based on the Medicare Parts C & D Fraud, Waste, and Abuse Training and General Compliance Training developed by the Centers for Medicare

More information

Cardinal McCloskey Services Corporate Compliance False Claims Act and Whistleblower Provisions

Cardinal McCloskey Services Corporate Compliance False Claims Act and Whistleblower Provisions Cardinal McCloskey Services Corporate Compliance False Claims Act and Whistleblower Provisions Purpose: Cardinal McCloskey Services is committed to prompt, complete and accurate billing of all services

More information

The Case For HIPAA Risk Assessment. Leader s Guide

The Case For HIPAA Risk Assessment. Leader s Guide 4547 The Case For HIPAA Risk Assessment Leader s Guide IMPORTANT INFORMATION FOR EDUCATION COORDINATORS & PROGRAM FACILITATORS PLEASE NOTE: In order for this program to meet Florida course requirements,

More information

You Probably Don t Even Know

You Probably Don t Even Know You Probably Don t Even Know That You Need To Comply With HIPAA In Collaboration With: About ERM About The Speaker Stephen Siegel, Esq., Of Counsel, Broad and Cassel Board Certified Health Law Over 25

More information

PROTECTING PATIENT PRIVACY and INFORMATION SECURITY

PROTECTING PATIENT PRIVACY and INFORMATION SECURITY PROTECTING PATIENT PRIVACY and INFORMATION SECURITY 2 PROTECTING PATIENT PRIVACY AND INFORMATION SECURITY PROTECTING PATIENT PRIVACY AND INFORMATION SECURITY 3 INTRODUCTION As an agency employee, student,

More information

HFS DATA SECURITY TRAINING WITH TECHNOLOGY COMES RESPONSIBILITY

HFS DATA SECURITY TRAINING WITH TECHNOLOGY COMES RESPONSIBILITY HFS DATA SECURITY TRAINING WITH TECHNOLOGY COMES RESPONSIBILITY Illinois Department of Healthcare and Family Services Training Outline: Training Goals What is the HIPAA Security Rule? What is the HFS Identity

More information

HIPAA Update Focus on Breach Prevention

HIPAA Update Focus on Breach Prevention HIPAA Update Focus on Breach Prevention Objectives By the end of this program, participants should be able to: Identify top reasons why breaches occur Review the breach definition and notification process

More information

Copyright 2016 State Volunteer Mutual Insurance Company. HIPAA Training for the Medical Office

Copyright 2016 State Volunteer Mutual Insurance Company. HIPAA Training for the Medical Office Copyright 2016 State Volunteer Mutual Insurance Company HIPAA Training for the Medical Office Disclaimer The information and any commentary contained in these training materials is for informational purposes

More information

HIPAA Privacy For our Group Customers and Business Partners

HIPAA Privacy For our Group Customers and Business Partners HIPAA Privacy For our Group Customers and Business Partners AmeriHealth HMO, Inc. AmeriHealth Insurance Company of New Jersey QCC Insurance Company, d/b/a AmeriHealth Insurance Company HIPAA, The Health

More information

PROGRAM INTEGRITY 101. Program Integrity Kimberly Sullivan, JD Medicaid Program Integrity Director

PROGRAM INTEGRITY 101. Program Integrity Kimberly Sullivan, JD Medicaid Program Integrity Director PROGRAM INTEGRITY 101 Program Integrity Kimberly Sullivan, JD Medicaid Program Integrity Director PURPOSE 2 Assure the Programmatic and Fiscal Integrity of the Louisiana Medical Assistance Program (Medicaid).

More information

HERITAGE FARM POLICY AND PROCEDURES. Policy: False Claims Act and Whistleblower Provisions

HERITAGE FARM POLICY AND PROCEDURES. Policy: False Claims Act and Whistleblower Provisions HERITAGE FARM POLICY AND PROCEDURES Policy: False Claims Act and Whistleblower Provisions Date: October 8, 2013 Rationale: It is Heritage Farm s intent to make sure all claims are submitted in a timely

More information

HIPAA Training: Ensuring Privacy for our Patients

HIPAA Training: Ensuring Privacy for our Patients HIPAA Training: Ensuring Privacy for our Patients The purpose of the HIPAA Privacy Rule is to prevent inappropriate use and disclosure of individual health information, most commonly referred to as protected

More information

Presented by Jack Kolk President ACR 2 Solutions, Inc.

Presented by Jack Kolk President ACR 2 Solutions, Inc. HIPAA 102 : What you don t know about the new changes in the law can hurt you! Presented by Jack Kolk President ACR 2 Solutions, Inc. Todays Agenda: 1) Jack Kolk, CEO of ACR 2 Solutions a information security

More information

HIPAA Self-Study Module Patient Privacy at Unity Health Care, Inc hipaa@unityhealthcare.org 202-667-0016 - HIPAA Hotline

HIPAA Self-Study Module Patient Privacy at Unity Health Care, Inc hipaa@unityhealthcare.org 202-667-0016 - HIPAA Hotline HIPAA Self-Study Module Patient Privacy at Unity Health Care, Inc hipaa@unityhealthcare.org 202-667-0016 - HIPAA Hotline Self-Study Module Requirements Read all program slides and complete test. Complete

More information

INTRODUCTION TO HIPAA COMPLIANCE UNDERSTAND YOUR PATHWAY TO HIPAA COMPLIANCE

INTRODUCTION TO HIPAA COMPLIANCE UNDERSTAND YOUR PATHWAY TO HIPAA COMPLIANCE INTRODUCTION TO HIPAA COMPLIANCE UNDERSTAND YOUR PATHWAY TO HIPAA COMPLIANCE INTRODUCTION TO HIPAA COMPLIANCE 2 ABOUT HIPAA COMPLIANCE Health Insurance Portability and Accountability Act (HIPAA) compliance

More information

Title: Preventing and Reporting Fraud, Waste and Abuse in Federal Health Care Programs. Area Manual: Corporate Compliance Page: Page 1 of 10

Title: Preventing and Reporting Fraud, Waste and Abuse in Federal Health Care Programs. Area Manual: Corporate Compliance Page: Page 1 of 10 Title: Preventing and Reporting Fraud, Waste and Abuse in Federal Health Care Programs Area Manual: Corporate Compliance Page: Page 1 of 10 Reference Number: I-70 Effective Date: 10/02 Contact Person:

More information

HIPAA And Public Health. March 2006 Delaware s Division of Public Health 1

HIPAA And Public Health. March 2006 Delaware s Division of Public Health 1 HIPAA And Public Health March 2006 Delaware s Division of Public Health 1 HIPAA The purpose for HIPAA (Health Insurance Portability & Accountability Act) is to protect the confidentiality, integrity, and

More information

THE STATE OF HEALTHCARE COMPLIANCE: Keeping up with HIPAA, Advancements in EHR & Additional Regulations

THE STATE OF HEALTHCARE COMPLIANCE: Keeping up with HIPAA, Advancements in EHR & Additional Regulations THE STATE OF HEALTHCARE COMPLIANCE: Keeping up with HIPAA, Advancements in EHR & Additional Regulations [ The State of Healthcare Compliance: Keeping up with HIPAA, Advancements in EHR & Additional Regulations

More information

HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) TERMS AND CONDITIONS FOR BUSINESS ASSOCIATES

HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) TERMS AND CONDITIONS FOR BUSINESS ASSOCIATES HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) TERMS AND CONDITIONS FOR BUSINESS ASSOCIATES I. Overview / Definitions The Health Insurance Portability and Accountability Act is a federal law

More information

HIPAA Privacy and Business Associate Agreement

HIPAA Privacy and Business Associate Agreement HR 2011-07 ATTACHMENT D HIPAA Privacy and Business Associate Agreement This Agreement is entered into this day of,, between [Employer] ( Employer ), acting on behalf of [Name of covered entity/plan(s)

More information