The HIPAA

1
The HIPAA Privacy Rule
2
INTRODUCTION
3
Privacy Training Roadmap
4
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INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES

• Did you know that Jim, Joe, and John in your
  office take Viagra?
• Did you know that your boss takes Prozac? Does
  this explain a lot?
• Do you really want everyone in your office to
  know about your head lice?

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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COMPLAINTS
SAFEGUARDS
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ACCESS
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INTRODUCTION
COVERED ENTITIES
PHI
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Should doctors or HMOs be allowed to sell your
health information to companies so they can
market their products to you including things
like pharmacies sending you Prozac in the mail?

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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COMPLAINTS
SAFEGUARDS
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INTRODUCTION
COVERED ENTITIES
PHI
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• Should you have to move mountains to get a copy
  of your health information?
• Did you know that 50 of the states do not allow
  you to see your medical records?

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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INTRODUCTION
COVERED ENTITIES
PHI
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Some things should be private!!
YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER

• Health Information should be at the Top of the
  List

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HIPAA The Big Picture
INTRODUCTION
COVERED ENTITIES
PHI
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YOUR RIGHTS

• Health Insurance Portability and Accountability
  Act
• Federal Mandate signed into law by President
  Clinton in 1996
• About Health Care Accessing and Keeping Health
  Information Private

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INTRODUCTION
COVERED ENTITIES
PHI
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Portability of Health Care
Department of Insurance 300 Spring Street Los
Angeles, CA 90013 [phone]
YOUR RIGHTS
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SANCTIONS

• MAY continue health insurance when changing
  jobs or leaving the workforce

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Administrative Simplification
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INTRODUCTION
COVERED ENTITIES
PHI
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YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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Just what is simple about HIPAA?
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11
The 7 HIPAA Rules for Administrative
Simplification
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INTRODUCTION
COVERED ENTITIES
PHI
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• Privacy
• Transactions and Code Sets
• Unique Identifiers
• Security
• Enforcement
• First Report of Injury
• Claim Attachments

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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COMPLAINTS
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12
The Privacy Rule
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INTRODUCTION
COVERED ENTITIES
PHI
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• HIPAA gives you the right to see your own health
  records
• You also get a say in how your information may be
  used and shared
• Giving More Rights to Individuals

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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What the HIPAA Privacy Rule Requires
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INTRODUCTION
COVERED ENTITIES
PHI
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YOUR RIGHTS
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• Appoint a Privacy Officer
• Provide Written Privacy Policies and Procedures
• Train Your Workforce

SANCTIONS
PRIVACY OFFICER
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INTRODUCTION
COVERED ENTITIES
PHI
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HIPAA Other Privacy Laws
YOUR RIGHTS
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• Privacy of health information is not new in
  California
• We already have many requirements for how health
  information can be used and shared

SANCTIONS
PRIVACY OFFICER
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COMPLAINTS
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COVERED ENTITIES
16
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PHI
INTRODUCTION
COVERED ENTITIES
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What is a Covered Entity?

• Most Health Care Providers
• Health Plans
• Health Care Clearinghouses

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PRIVACY OFFICER
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COVERED ENTITIES
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Health Care Provider

• A provider of medical or other health care
  services
• Or any other person or organization who
• Furnishes,
• Bills, or
• Is paid for health care

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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BUT!
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INTRODUCTION
COVERED ENTITIES
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• Health Care Providers must use one or more of the
  electronic standard transactions to be considered
  a covered entity.
• For example, they bill a health plan using an 837
  standard code for a service provided.

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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INTRODUCTION
COVERED ENTITIES
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• Some providers include
• Hospitals
• Clinics
• Doctors
• Dentists
• Clinical Social Workers
• Psychiatrists

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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INTRODUCTION
COVERED ENTITIES
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A Health Plan
YOUR RIGHTS

• An individual plan or group plan that
• Pays the cost of medical care
• Provides for the cost of medical care, or

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SANCTIONS
PRIVACY OFFICER
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INTRODUCTION
COVERED ENTITIES
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• Some Health Plans include
• Group health plans
• Health Maintenance Organizations (HMOs)
• Medicare
• Medi-Cal
• Veterans health programs

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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A Health Care Clearinghouse
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INTRODUCTION
COVERED ENTITIES
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YOUR RIGHTS

• An entity that processes nonstandard codes of
  health information into standard codes.

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PRIVACY OFFICER
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INTRODUCTION
COVERED ENTITIES
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Health Care Clearinghouse

• Takes a bill from a provider for casting a broken
  leg
• Applies the national standard code for broken leg
  casts
• Uses the standard code to forward the bill in a
  standard transaction format to the health plan
  for payment

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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INTRODUCTION
COVERED ENTITIES
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• Some Health Care Clearinghouses may be
• Billing Services
• Re-Pricing Companies
• Community Health Management
• Information Systems
• Value-Added Networks
• or Switches

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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INTRODUCTION
COVERED ENTITIES
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Hybrid Entities

• A single legal entity
• A covered entity
• Business activities include covered and
  non-covered functions
• Has health care components.

YOUR RIGHTS
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PRIVACY OFFICER
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INTRODUCTION
COVERED ENTITIES
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• Some organizations are designating themselves as
  a hybrid entity.
• County government
• A small manufacturing firm and its health clinic
• California Department of Health Services

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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Organized Health Care Arrangement (OHCA)
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INTRODUCTION
COVERED ENTITIES
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YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER

• The clinical or operational sharing among legally
  separate covered entities.

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INTRODUCTION
COVERED ENTITIES
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• Some OHCAs include
• Hospitals with care provided by more than one
  health care provider
• Organized systems of health care with joint
  activities
• Group health plans maintained by the same sponsor

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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INTRODUCTION
COVERED ENTITIES
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• Business Associates
• A business Associate is a person or organization
  that
• On behalf of a covered entity performs any
  function or activity covered by HIPAA
• On behalf of a covered entity provides a service
  on behalf of a covered entity involving the
  transfer of PHI

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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INTRODUCTION
COVERED ENTITIES
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• Some Business Associates may include
• A Law Firm
• An Accounting Firm
• A Consulting Company that Provides Data Analysis
• A Third-Party Auditing Agency
• An Accreditation Agency

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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INTRODUCTION
COVERED ENTITIES
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• Our department determined it is a
  ______________________________
• This means that HIPAA applies to functions we
  perform including
• ________________________
• ________________________
• ________________________

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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COMPLAINTS
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HEALTH INFORMATION
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INTRODUCTION
COVERED ENTITIES
PHI
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INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION

• (IIHI)
• Created, received by a provider,
• health plan or clearinghouse.
• Relates to the health condition of an
• individual
• Relates to payments for health care
• services
• Identifies the individual

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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INTRODUCTION
COVERED ENTITIES
PHI
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Protected Health Information

• Protected Health Information (PHI) is any IHI
  that is under the control of a covered entity.
• It may be
• Transmitted electronically
• Kept in any medium
• Transmitted or kept in any other form

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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INTRODUCTION
COVERED ENTITIES
PHI
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• PHI may be in any form
• Paper
• Electronic
• Oral
• Faxes
• Other

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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INTRODUCTION
COVERED ENTITIES
PHI
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What is not PHI?

• De-identified health information
• Health information maintained
• by non-covered entities
• Some schools records
• Employer records

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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INTRODUCTION
COVERED ENTITIES
PHI
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YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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INTRODUCTION
COVERED ENTITIES
PHI
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• CAN YOU THINK
• OF ANY PHI IN YOUR JOB?

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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YOUR RIGHTS
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PHI
INTRODUCTION
COVERED ENTITIES
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Your Rights
YOUR RIGHTS
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• HIPAA does not just apply to those we serve.
• It applies to us, too!
• These rights are also your rights!

SANCTIONS
PRIVACY OFFICER
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INTRODUCTION
COVERED ENTITIES
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• Individuals (YOU) have the right to
• A Notice of Privacy Practices
• PHI privacy
• Have access to PHI
• Have a person act on your behalf
• Not sign an authorization
• Request limits on who sees your PHI
• Know who sees your PHI

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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INTRODUCTION
COVERED ENTITIES
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• Individuals (YOU) have the right to
• See PHI in Private
• Request Amendments to Your PHI
• Receive an Accounting of Disclosures of PHI
• File a Complaint
• No Retaliation
• Stop Release of PHI after You Have Said It Is OK

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
REMEMBER, THESE ARE YOUR RIGHTS TOO!!
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INTRODUCTION
COVERED ENTITIES
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• Notice of Privacy Practices
• We must provide a copy of our Notice of
  Privacy Practices to our customers.

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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COMPLAINTS
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PRIVACY OFFICER
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Privacy Officer
PHI
INTRODUCTION
COVERED ENTITIES
4 SLIDES

• Every Covered Entity must have a privacy
  officer, who is responsible for
• Your departments Privacy Policies and Procedures
• Implementing HIPAA Privacy Rule
• Overseeing HIPAA in your department

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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INTRODUCTION
COVERED ENTITIES
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• Our Privacy Officer Is
• Name
• Address
• Telephone Number
• Email Address

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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ACCESS
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PHI
INTRODUCTION
COVERED ENTITIES
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Access to PHI

• Access by an individual is
• Seeing PHI
• Receiving copies of PHI

YOUR RIGHTS
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SANCTIONS
You, too, have the right to see your health
information!
PRIVACY OFFICER
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DESIGNATED RECORD SETS

• Information used to make decisions about
• individuals
• For Providers
• Medical records
• Billing records
• For Health Plans
• Enrollment, payment, and claim records

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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Who Can Access PHI?
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INTRODUCTION
COVERED ENTITIES
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• Only Individuals Whose PHI We Maintain
• OR
• Personal Representatives of Individual
• -MUST VERIFY IDENTITY-

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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Where to Access PHI
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INTRODUCTION
COVERED ENTITIES
4 SLIDES

• Who do you refer people to when they request
  access to their records?
• Name
• Address
• Telephone Number
• Email Address

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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Requests for PHI
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INTRODUCTION
COVERED ENTITIES
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• Format
• Time Limits
• Fees for Copies

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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Confidential Access
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INTRODUCTION
COVERED ENTITIES
4 SLIDES

• Other Places and Ways to Access PHI
• Our Confidential Ways
• (Samples Mail, email, fax)
• Our Confidential Places
• (Samples District offices, other government
  agency offices, etc.)

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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Denials of Access
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INTRODUCTION
COVERED ENTITIES
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• Exempt from Access
• Psychotherapy Notes
• Clinical Laboratory Information
• Clinical Laboratory Testing Results involving
  Human Subjects

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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Denials of Access
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INTRODUCTION
COVERED ENTITIES
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• No Reviews
• Jails or prisons no copies to inmates
• Research Project
• Privacy Act
• Promise of Confidentiality

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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Denials of Access
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INTRODUCTION
COVERED ENTITIES
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• Reviewable Reasons
• Endangers Life or Safety of
• Individual
• Person Named in Record
• Individual by Personal Representative

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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COVERED ENTITIES
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Review Process
YOUR RIGHTS
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• Right to Ask for Review
• By Licensed Health Care Professional
• Must Adhere to Decision

SANCTIONS
PRIVACY OFFICER
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Amendments to PHI
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INTRODUCTION
COVERED ENTITIES
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YOUR RIGHTS

• Right To Request Amendments
• If Accepted, within 60 days
• Amend record
• Inform Individual
• Inform Others

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SANCTIONS
PRIVACY OFFICER
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Denied Requests for Amendments
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INTRODUCTION
COVERED ENTITIES
4 SLIDES

• Requests Denied
• In Writing
• Basis for Denial
• Within 60 days
• Right to Submit a Statement If You Disagree

YOUR RIGHTS
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SANCTIONS
PRIVACY OFFICER
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5 SLIDES
16 SLIDES
3 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
60
Reasons for Denial of Amendments
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
4 SLIDES
YOUR RIGHTS

• Not created by Department
• Not part of Designated Record Set
• Access to Record Was Denied
• Is Accurate and Complete

3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
3 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
61
Actions if Denied
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
4 SLIDES

• If Request to Amend is Denied
• Statement of Disagreement
• Rebuttal

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
3 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
62
Other Requirements
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
4 SLIDES

• Future Disclosures
• Other Covered Entities Changes
• Revise Record

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
3 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
63
USE AND DISCLOSUREOF PHI
64
Order of Presentation
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES

• Rule
• Definitions
• Minimum Necessary
• When to Use/Disclose
• Authorizations
• Treatment, Payment, Operations
• Must Disclose
• Need Individual Agreement
• Public Policy
• Incidental
• Individual Rights
• Request Restrictions
• Accounting of Disclosures
• Questions
• Remember

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
65
Privacy Training Roadmap The Detour
66
The Rule
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES

• Covered entities may not use or disclose PHI,
  without an authorization from the individual,
  except as allowed by HIPAA
• Applies to
• Covered Entities
• Workforce Members
• Business Associates

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
67
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES

• DEFINITIONS
• USE Internal Use of PHI by an Entity
• DISCLOSURE Release of PHI to persons or
  organizations outside the Covered Entity
  (Department or County)

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
68
Minimum Necessary
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES
YOUR RIGHTS

• Smallest amount of PHI that is needed to
• Do the job, or
• Meet the needs of the person asking for the PHI
• HIPAA limits most uses and disclosures of PHI to
  the minimum amount needed.

3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
69
Permissions
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES

• To Use PHI You Must Provide
• A Notice of Privacy Practices
• A Consent Form (Optional)
• To Disclose PHI You Need to Verify Identity

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
156 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
70
Rules for Allowed Usages and Disclosures
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES
YOUR RIGHTS

• No Authorization is Needed
• Minimum Necessary Applies
• Documentation Required

3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
71
Allowed Uses and Disclosures
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES

• Authorizations
• Treatment, Payment, Operations
• Must Disclose
• Need Individual Agreement
• Public Policy
• Incidental

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
72
Authorizations
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES

• Required for
• Psychotherapy Notes
• Marketing
• Required Form Signed by Individual
• Right to Take Back
• No Authorization, No Treatment

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
73
TPO
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES
YOUR RIGHTS
3 SLIDES

• Treatment
• Payment
• Health Care Operations

SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
74
TREATMENT
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES
YOUR RIGHTS
3 SLIDES

• Treatment is the provision of health care to an
  individual
• Treatment only applies to health care providers
• Minimum Necessary does NOT apply

SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
75
PAYMENT
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES

• Payment includes activities to
• Obtain premiums if you are a health plan
• Obtain money for services if you are a provider.
• Minimum Necessary Applies
• Authorization NOT Required

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
76
HEALTH CARE OPERATIONS
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES

• Health Care Operations support treatment and
  payment
• Limited to Our Operations
• Activities in 6 Areas
• Minimum Necessary Applies
• An Authorization is NOT Needed

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
77
Must Disclose
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES

• Individual Access
• Secretary of the U.S. Department of Health and
  Human Services

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
78
Opportunity to Agree or Object
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES

• Use or Disclosure of PHI
• Facility Directories
• Disaster Relief
• Disclosure of PHI
• Family Members

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
79
Public PolicyUses and Disclosures
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES
YOUR RIGHTS

• Use and Disclosure when
• Required by Law
• Minimum Necessary NOT Required

3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
80
Public PolicyUses and Disclosures
12 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES

• MINIMUM NECESSARY APPLIES TO ALL OF THE FOLLOWING
  ACTIVITIES
• Use and Disclosure for
• Public Health Activities
• Health Oversight Activities
• Judicial or Administrative Proceedings
• Deceased Individuals

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
15 SLIDES
5 SLIDES
5 SLIDES
23 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
81
Public PolicyUses and Disclosures
12 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES

• Use and Disclosure for
• Organ Donations
• Research
• Health and Safety
• Government Functions
• Fundraising for Own Organization

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
15 SLIDES
5 SLIDES
5 SLIDES
23 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
82
Public PolicyUses and Disclosures
12 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES
YOUR RIGHTS

• Disclosure ONLY
• Victims of Abuse, Neglect or Domestic Violence
• Workers Compensation
• Law Enforcement
• REMEMBER Minimum Necessary Applies

3 SLIDES
SANCTIONS
PRIVACY OFFICER
15 SLIDES
5 SLIDES
5 SLIDES
23 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
83
Incidental Disclosures
12 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES

• What Are These?
• Minimum Necessary
• and Safeguards
• Examples

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
15 SLIDES
5 SLIDES
5 SLIDES
23 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
84
Restricted Disclosures
12 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES
YOUR RIGHTS

• Right to Request Restriction on Disclosures
• May Be Denied
• Must Be Documented

3 SLIDES
SANCTIONS
PRIVACY OFFICER
15 SLIDES
5 SLIDES
5 SLIDES
23 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
85
Accounting of Disclosures
12 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES
YOUR RIGHTS

• Individuals Right
• Disclosures for Last 6 Years

3 SLIDES
SANCTIONS
PRIVACY OFFICER
15 SLIDES
5 SLIDES
5 SLIDES
23 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
86
Exceptions to Accounting
12 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES

• Except No Accounting needed for these
  activities
• Authorizations
• Facility Directories
• Family Members

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
15 SLIDES
5 SLIDES
5 SLIDES
23 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
87
Exceptions to Accounting
12 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES
YOUR RIGHTS

• Except Disclosures for
• Treatment, Payment and Health Care Operations
• Individuals
• Incidental Situations
• National Security or Intelligence
• Jails, Prisons, or Law Enforcement
• Limited Data Sets for Research

3 SLIDES
SANCTIONS
PRIVACY OFFICER
15 SLIDES
5 SLIDES
5 SLIDES
23 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
88
Questions?????
12 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES

• If you have questions about use or disclosure of
  PHI, where do you go?
• To your Supervisor first, then your Privacy
  Officer

YOUR RIGHTS
3 SLIDES
Name Telephone Number Address
SANCTIONS
PRIVACY OFFICER
15 SLIDES
5 SLIDES
5 SLIDES
23 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
89
REMEMBER
12 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES

• You may not use or disclose PHI unless it is for
  one of the purposes you just learned.

YOUR RIGHTS
Do not stick your neck out if you do not know
if it is OK, ask your supervisor or
_____________, our Privacy Officer.
3 SLIDES
SANCTIONS
PRIVACY OFFICER
15 SLIDES
5 SLIDES
5 SLIDES
23 SLIDES
26 SLIDES
COMPLAINTS
SAFEGUARDS
USE DISCLOSURE
ACCESS
90
SAFEGUARDS
91
Safeguards
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES

• HIPAA requires that covered entities safeguard
  PHI in two ways
• Administrative, technical and physical safety for
  PHI that is paper
• Electronic safeguards for PHI stored or processed
  by computers

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
16 SLIDES
3 SLIDES
COMPLAINTS
ACCESS
USE DISCLOSURE
92
Unprotected PHI
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES

• What do you do if you see PHI that is not
  protected?
• Report it to your supervisor immediately!
• If not, report to their supervisor.
• Report it to ____________________

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
16 SLIDES
3 SLIDES
COMPLAINTS
ACCESS
USE DISCLOSURE
93
REMEMBER
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
PHI
4 SLIDES

• Protect PHI you come in contact with.
• It is confidential ---- forever.
• Dont Gossip about PHI
• Report Problems

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
16 SLIDES
3 SLIDES
COMPLAINTS
ACCESS
USE DISCLOSURE
94
COMPLAINTS
95
Who May Complain
14 SLIDES
16 SLIDES
PHI
INTRODUCTION
COVERED ENTITIES
4 SLIDES

• Individuals
• Whistleblowers

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
3 SLIDES
COMPLAINTS
ACCESS
USE DISCLOSURE
SAFEGUARDS
96
Complain about what???
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
4 SLIDES

• Privacy Policies
• Misuse of PHI
• Denial of Access to PHI
• Denial of Changes to PHI

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
3 SLIDES
COMPLAINTS
ACCESS
USE DISCLOSURE
SAFEGUARDS
97
Complaint Officer
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
4 SLIDES

• Complaints may be filed with

YOUR RIGHTS
3 SLIDES
Name Complaint Officer Telephone Number
Email Address
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
3 SLIDES
COMPLAINTS
ACCESS
USE DISCLOSURE
SAFEGUARDS
98
To whom may complaints be filed?
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
4 SLIDES

• Secretary
• U.S. Department of Health
• and Human Services
• Office for Civil Rights
• Attention Regional Manager
• 50 United Nations Plaza, Room 322
• San Francisco, CA 94102
• [phone]

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
23 SLIDES
3 SLIDES
COMPLAINTS
ACCESS
USE DISCLOSURE
SAFEGUARDS
99
No Retaliation
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
4 SLIDES

• Intimidation
• Threats
• Coercion
• Discrimination
• Retaliation

• Individuals have the right to NO

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
3 SLIDES
COMPLAINTS
ACCESS
USE DISCLOSURE
SAFEGUARDS
100
SANCTIONS
101
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
4 SLIDES
Sanctions Penalties

• Sanctions for violating Privacy Policies and
  Procedures
• Existing disciplinary processes will be used

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
3 SLIDES
COMPLAINTS
ACCESS
USE DISCLOSURE
SAFEGUARDS
102
Examples of Violations
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
4 SLIDES

• Shares PHI with Others at Break
• Uses PHI to Send a Birthday Card
• Sells PHI to a Marketing Firm
• Posts a List of Patients on the Internet

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
3 SLIDES
COMPLAINTS
ACCESS
USE DISCLOSURE
SAFEGUARDS
103
Example State Disciplinary Process
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
4 SLIDES
YOUR RIGHTS

• State Disciplinary System calls for three phases
  of discipline
• 1) Prevention
• 2) Corrective Action
• 3) Disciplinary or Adverse Actions

3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
3 SLIDES
COMPLAINTS
ACCESS
USE DISCLOSURE
SAFEGUARDS
104
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
4 SLIDES
Statement of Understanding

• You may be asked to sign a statement that you
  understand
• The Privacy Policies and Procedures
• That You Must Keep PHI Confidential
• For more information
• Your Supervisor
• The Privacy Policies and Procedures
• Training Handouts

YOUR RIGHTS
3 SLIDES
SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
3 SLIDES
COMPLAINTS
ACCESS
USE DISCLOSURE
SAFEGUARDS
105
Civil and Criminal Penalties
14 SLIDES
16 SLIDES
INTRODUCTION
COVERED ENTITIES
4 SLIDES
YOUR RIGHTS
3 SLIDES

• HIPAA Civil and Criminal Penalties
• State Law Penalties
• Federal Enforcement Rule
• Up to 250,000 and 10-years in prison for
  obtaining or disclosing PHI with the intent to
  sell, transfer, or use for commercial advantage,
  personal gain, or malicious harm.

SANCTIONS
PRIVACY OFFICER
3 SLIDES
5 SLIDES
5 SLIDES
16 SLIDES
3 SLIDES
COMPLAINTS
ACCESS
USE DISCLOSURE
SAFEGUARDS
106
Privacy Training Roadmap The Detour