HIPAA COMPLIANCE

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HIPAA COMPLIANCE

• WHAT YOU NEED TO KNOW ABOUT HIPAA.

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WHAT IS HIPAA?

• Health Insurance Portability Accountability Act
  of 1996 (Federal Law).
• New rules to safeguard employees Protected
  Health Information (PHI).
• Mandates the development of national standards
  and requirements to enable the electronic
  exchange of certain PHI.

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EXAMPLES OF PHI

• Explanation of Benefits (EOB)
• Doctors Certification
• Copies of anything pertaining to hospital and
  medical benefits medical, dental, reimbursement
  accounts and vision.

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Who must comply with HIPAA?

• Covered Entities organizations bound by the
  privacy standards were required to comply by
  April 14, 2003.
• A Health Plan.
• A Health care clearinghouse.
• A Health care provider who transmits any health
  information in electronic form. Examples
  medical, dental flexible spending accounts
  (health care reimbursement)

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How do we comply with HIPAA?

• The privacy rule requires covered entities to
  make reasonable efforts to limit use and
  disclosure of PHI to the fewest people necessary.
  
• ONLY the information obtained or created by MDCs
  health plan will be regulated by the HIPAA
  requirements.
• PHI specifically excludes employment records.

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What is our Role with HIPAA?

• Treat PHI as Private and Confidential.
• Do not transmit or communicate such PHI to anyone
  other than the employee, unless we have the
  employees written permission to do so.
• When responding to an email containing PHI, Do
  Not copy anyone.
• Follow a few simple procedures to ensure
  compliance with the new rule.

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The Colleges Role with HIPAA

• The Colleges
• practice is to treat employees personal
  information with confidentiality.
• Policy II-81A was established to ensure that MDC
  complies with HIPAA regulations.
• www.MDC.edu/policy/Chapter2/02-II-81A.pdf
• systems do not access, use or disclose Protected
  Health Information PHI.

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To Whom should PHI requests be referred?

• Requests from the employee for their own PHI
  refer to Cigna
• Requests for PHI from other than the person who
  is the subject of information refer to Cigna
• If unsuccessful with Cigna refer to Janik
  Collin, Benefits Dept. for assistance with
  claims. Fax requests authorization to (305)
  237-0322 or email jcollin_at_mdc.edu

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Summary

• HIPAA is a Federal law that protects employees
  health information.
• MDC only contracts with providers that comply
  with HIPAA regulations.