What is the purpose of the hipaa law

The Health Insurance Portability And Accountability Act (HIPAA) was signed into law in the year 1996, by President Bill Clinton. It is a legislation which provides security provisions and data privacy, in order to keep patients’ medical information safe. The act contains five titles, or sections, in total:

  • HIPAA Title I aims to protect coverage of health insurance for those who have changed or lost their jobs. It prevents group health plans from refusing to cover individuals who have pre-existing diseases or conditions, and prohibits them from setting limits for lifetime coverage.
  • HIPAA Title II aims to direct the United States Department Of Human Services and Health in order to standardize the processing of electronic healthcare transactions nation-wide. It requires the organizations to implement safe electronic access to the patients’ health data, remaining in compliance with the privacy regulations which were set by the HHS.
  • HIPAA Title III is related to provisions which are tax-related, as well as general medical care guidelines.
  • HIPAA Title IV defines a further reform in health insurance, including provisions for those who have pre-existing diseases or conditions, and individuals who are seeking continued coverage.
  • HIPAA Title V includes provisions associated with company-owned insurance, and treatment of those who lost their citizenship for income tax reasons.

Most of the time, in IT circles, people who refer to HIPAA compliance mean adhering to the Title II. it is also known as ‘Administrative Simplification’ provisions, and includes following the HIPAA compliance requirements above:

  • National Provider Identifier Standard. This requires that every single health care entity, like employers, individuals, healthcare providers and health plans, need to have a unique 10-digit provider identifier code – their NPI (National Provider Identifier).
  • Transactions and Code Sets Standards. This orders organizations to follow a standard mechanisms for EDI (electronic data interchange), when processing or submitting insurance claims.
  • HIPAA Privacy Rule. This rule aims to establish national standards that protect patients’ health information, make sure any individually identifiable information is safe.
  • HIPAA Security Rule. This rule sets standards for patients’ data security as well.
  • HIPAA Enforcement Rule. Lastly, this rule establishes the guidelines for investigating violations of HIPAA.

In the year 2013, HHS put in place the HIPAA Omnbius Rule, in order to implement a few modifications to the earlier version, in accordance with certain guidelines, which were set in 2009 by the HITECH Act. It concerns mostly the responsibility of business associates of the entities that are covered. This rule also makes change to the penalties for violations of HIPAA compliance, increasing them to a maximum of 1.5 million dollars per incident.

HIPAA violations can be very costly for a health care organization. First of all, the Breach Notification Rule, set in the omnibus, requires that the entities which are covered as well as any of their business associates notify patients that they are following a data breach. In addition to these costs, the organizations may encounter fines after the audits get conducted by the Office of Civil Rights (OCR). Providers may even face criminal charges for violation of such rules.

Organizations are able to lower the risk of regulatory action by taking practice in training programs for HIPAA compliance. The OCR offers six programs in total which aim to educate employees about the security and privacy rules. Many other training groups and consultancies offer programs, too. Providers may even create their own programs, encompassing other areas such as the current HIPAA policies, the HITECH Act and management processes from mobile devices and other certain applicable guidelines.

There is no official certification program for HIPAA compliance, but many training companies offer credentials which indicate the understanding of guidelines and regulations the act specifies.

Grow your system, profitably. See why the largest systems in the US choose eVisit.

Congress introduced the Health Insurance Portability and Accountability Act (HIPAA) 1996, and since then HIPAA has changed the landscape of data protection in the healthcare industry. Initially, HIPAA’s primary function was to address the issue of health insurance coverage for individuals between jobs. Before HIPAA, individuals in this situation could find themselves without healthcare coverage, and therefore potentially unable to access crucial medical treatment. HIPAA’s purpose was to allow individuals to access healthcare coverage even if they were out of work.

It is HIPAA’s secondary purpose that has made it such a significant piece of healthcare legislation: the introduction of industry-wide standards of patient data protection in the United States healthcare industry. HIPAA enforces strict stipulations regarding the safeguarding of protected healthcare information (PHI). Hackers and others with criminal intent may attempt to access PHI to use it for nefarious purposes such as identity theft. Fraud can have long-lasting and devastating effects for its victims. One of HIPAA’s primary purposes is to require organisations to improve the level of security placed on sensitive data.

If the regulatory authority finds an organisation in violation of HIPAA’s rules, they are authorised to levy hefty financial penalties against the organisation. These penalties act as significant deterrents to organisations who may otherwise ignore HIPAA’s Rules.

HIPAA is a comprehensive legislative act incorporating the requirements of several other legislative acts, including the Public Health Service Act, Employee Retirement Income Security Act, and more recently, the Health Information Technology for Economic and Clinical Health (HITECH) Act.

HIPAA comprises of a set of Rules, each with a particular function. The purpose of each rule is outlined below.

The Privacy Rule of 2000

The purpose of the HIPAA Privacy Rule was to introduce restrictions on the allowable uses and disclosures of protected health information. The Rule stipulates when, with whom, and under what circumstances health information could be shared. Only authorised individuals may access PHI; access by an unauthorised individual, whether by accident or through a deliberate hacking attempt, may incur financial penalties if the organisation did not have adequate safeguards in place.

The HIPAA Privacy Rule also gives patients some control over their data. For example, patients also can authorise who can see their medical information. Furthermore, patients can request an organisation to give them access to their health data. An organisation must securely deliver the individual’s data and within 30 days of the request.

The Security Rule of 2003

The HIPAA Security Rule requires organisations to use administrative, technical, and physical safeguards to protect electronic health data. Covered entities must ensure the confidentiality, integrity, and availability of all e-PHI they create, receive, maintain or transmit. An auditable trail of PHI activity must be maintained, with access to any PHI carefully recorded and controlled. Furthermore, covered entities must ensure that they protect against “reasonably anticipated threats” to the security of PHI.

The Breach Notification Rule of 2009

The purpose of the Breach Notification Rule of 2009 is to inform organisations of their responsibilities in the event of a data breach. The Breach Notification Rule states that covered entities must provide notification of the breach to affected individuals, the Secretary, and, if the breach is of a significant scale, to the media. The Rule also covers business associates, who must notify covered entities if a breach occurs at or by the business associate. The Breach Notification Rule requires organisations to notify those affected by the breach that their PHI has been compromised without “reasonable delay”, and no later than 60 days after the breach has occurred.

Other Purposes of HIPAA

Some of HIPAA’s other purposes surround introducing several reforms to improve bureaucracy in the healthcare industry. HIPAA legislation requires compliant healthcare organisations to adopt new standards and practices to increase efficiency in the healthcare system. HIPAA requires healthcare professionals to use code sets along with patient identifiers, which helped pave the way for the efficient transfer of healthcare data between healthcare organisations and insurers. This streamlined process allows for efficient eligibility checks, billing, payments, and other healthcare operations, thus improving a patient’s experience in the healthcare system.

HIPAA also prohibits the tax-deduction of interest on life insurance loans, enforces group health insurance requirements, and standardises the amount that individuals may place in a pre-tax medical savings account.

Conclusion

HIPAA has a wide range of purposes across all areas of the healthcare industry. It seeks to improve efficiency in the healthcare industry, to improve the portability of health insurance, to protect the privacy of patients and health plan members, and to ensure health information is kept secure and patients are notified of breaches of their health data.

What is the purpose of HIPAA quizlet?

What is the purpose of HIPAA? To standardize Health care transactions as well as rules which protect the privacy and security of health information.

What are the four main purposes of HIPAA quizlet?

What are the four main purposes of HIPAA? Privacy of health information, security of electronic records, administrative simplification, and insurance portability. Provides detailed instructions for handling a protecting a patient's personal health information.