HIPAA (Health Insurance Portability Accountability Act of 1996)
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Learning Objectives
After completion of the course you’ll be able to:
Privacy Rule: General Topics
- List 5 things that the HIPAA Privacy Rule requires the average provider or health plan to do.
- Describe how the HIPAA Privacy Rule protects individuals’ medical records and other personal health information.
Covered Entities
- Explain which entities are covered by the Privacy Rule by following decision trees.
Business Associate
- Define business associate, provide several examples of business associates, and frame a business associate contract.
Permitted Uses and Disclosures
- Discuss six permitted uses and disclosures of protected health information.
Minimum Necessary
- Define the HIPAA Privacy Rule’s minimum necessary standard and its application in the use and disclosure of protected health information.
Right to Access Medical Records
- Explain the right of access to the protected health information afforded to patients under the HIPAA Privacy Rule.
Right to Amend Medical Records
- Explain the right to amend the protected health information afforded to patients under the HIPAA Privacy Rule.
Right to Accounting Disclosures
- Explain the right to an accounting of disclosures of protected health information afforded to patients under the HIPAA Privacy Rule.
Incidental Uses and Disclosures
- Discuss various situations where incidental uses and disclosures of protected health information are permitted under the Privacy Rule.
- Provide examples of reasonable safeguards a covered entity must implement to limit incidental, and avoid prohibited, uses and disclosures of protected health information.
Public Health Uses and Disclosures
- Explain how a covered entity can disclose protected health information to a public health authority and comply with the requirement to provide individuals with an accounting for disclosures.
Marketing Uses and Disclosures
- Define marketing and distinguish between what is marketing and what is not marketing under the HIPAA Privacy Rule.
- Discuss situations when an authorization is required from the patient before a provider or health plan can engage in marketing to that individual.
- Distinguish between activities for treatment or health care operations versus marketing activities.
- Identify two circumstances when a patient’s prior authorization is required for the use and disclosure of protected health information for marketing.
Workers’ Compensation
- Discuss how the Privacy Rule works with respect to disclosures for workers’ compensation.
Limited Data Set
- Discuss the requirement of limited data set.
- Discuss the use and disclosure of limited data set to a business associate under the HIPAA Privacy Rule.
Notice of Privacy Practices
- Discuss the right provided by the Privacy Rule to individuals to receive a notice of privacy practices for protected health information, and specify the content of the notice.
- Identify three entities who are not required to develop a notice of privacy practices.
Personal Rep/Parents and Minors
- Identify individuals and circumstances under which these individuals can have access to protected health information of minors or other individuals.
Research Uses and Disclosures
- Explain the application of HIPAA Privacy Rule in research uses and disclosures of protected health information.
Administrative Simplification
- Discuss the implementation of administrative simplification requirements by HHS.
Learning Objectives
- Protecting the Privacy of Patient’s Health Information
- Overview
- Patient Protections
- Health Plans and Providers
- Outreach and Enforcement
- Summary of the HIPAA Privacy Rule
- Introduction
- Statutory & Regulatory Background
- Who Is Covered by The Privacy Rule
- Definitions
- Business Associates
- What Information Is Protected
- General Principle for Uses and Disclosures
- Permitted Uses and Disclosures
- Authorized Uses and Disclosures
- Limiting Uses and Disclosures to the Minimum Necessary
- Notice and Other Individual Rights
- Administrative Requirements
- Organizational Options
- Other Provisions: Personal Representatives and Minors’ Personal Representatives
- State Law
- Enforcement and Penalties for Noncompliance
- Compliance Dates
- Copies of the Rule & Related Materials
- Incidental Uses and Disclosures
- Minimum Necessary
- Personal Representatives
- Business Associates
- Uses and Disclosures for Treatment, Payment, and Health Care Operations
- Marketing
- Disclosures For Public Health Activities
- Research
- Disclosures For Workers’ Compensation Purposes
- Notice of Privacy Practice For Protected Health Information
- Restrictions on Government Access to Health Information
- Implementation of Administrative Simplification Requirements by HHS
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- Overview
- Implementation Plan
- Standards Adoption Process
- Public and Private Sector Input into the Standards Development Process
- Implementation Schedule
- Understanding CMS’s Compliance Policy
- What Is a Contingency Plan?
- Steps For Contingency Planning
- Health Plan Responsibilities
- Review Your Good Faith Efforts to Comply
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- Security Standard
- General Approach
- Specific Requirements
- Guidance on Compliance with HIPAA Transactions and Code Sets After the October 16, 2003 ImplementationDeadline
- Enforcement Approach
- Working Toward Compliance
- HIPAA Administrative Simplification Compliance Act (ASCA)
- Electronic Transaction Standards
- Code Set Standards
- What Is a Code Set
- What Code Sets Have Been Adopted as HIPAA Standards?
- FAQ About HIPAA
- HIPAA: In General
- Privacy Rule: General Topics
- Protected Health Information
- Preemption of State Law
- Covered Entities
- Compliance Dates
- Minimum Necessary
- Business Associates
- Treatment/Payment/Health Care Operations
- Right to Access Medical Records
- Complaints
- Right to an Accounting of Disclosures
- Incidental Uses and Disclosures
- Public Health Uses and Disclosures
- Facility Directories
- Disclosure to Family and Friends
- Disclosures Required by Law
- Disclosures for Rule Enforcement
- Disclosures for Law Enforcement Purposes
- Authorizations
- Marketing Uses and Disclosures
- Workers’ Compensation Disclosures
- Notice of Privacy Practices
- Personal Reps/Parents and Minors
- Limited Data Set
- Research Uses and Disclosures
- Transition Provision
Appendix A: Notice of Privacy Practices
Appendix B: Sample Business Associate Contract
Appendix C: How to File a Health Information Privacy Complaint With the Office For Civil Rights