Health Insurance Portability and Accountability Act

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Health Insurance Portability and Accountability
Act

• By Bradley Gleich

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Pre-HIPAA

• Over 400 different insurance forms
• System to System differences
• Professionalism
• Lack of Audits
• Lack of Protection

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Title I Health Care Access, Portability, and
Renewability

• Protects against discrimination of service of
  public insurance based on preexisting conditions
• Prohibits premiums changes on group policies
  based on prior individual conditions
• Allows for exception as to when a person can
  apply for health coverage

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Title II Administrative Requirements

• EDI/Code standardization
• ICD-9/10
• CPT-4
• NDC
• HLC
• Insurance Claim Reform
• Form Simplification
• Form Reduction

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Title II Privacy Requirements

• Protected Healthcare Information (PHI)
• Any information that can identify the patient
• Need to Know
• Patients right to know medical record
• Patients right to correct medical record
• Patients right to know how record used

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Title II Security Requirements

• Physical Safeguards
• Access to equipment containing PHI
• Timed Software Lockout
• Computer Locks
• Facility Security
• Guest Escort Rules
• PHI discreetness
• Adjusted Monitors
• Protect Patient Charts
• Protected/Vague Phone Calls
• Vague Electronic Communication

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Title II Security Requirements

• Technical Safeguards
• Passwords
• Data Encryption
• Data integrity NO RE-WRITE or DELETE
• Network Security
• Rights Management

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Title II Security Requirements

• Paper Trail
• Documentation of all Security Standards
• Documentation of all Security Implementations
• Documentation of Disaster Recovery
• Documentation of Standard Practices
• Documentation of Risk Analysis and Management

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Sources

• http//www.dol.gov/ebsa/newsroom/fshipaa.html
• http//www.hhs.gov/news/facts/privacy.html
• http//www.hhs.gov/ocr/hipaa/
• http//en.wikipedia.org/wiki/HIPAA