Privacy and Confidentiality

1. Privacy and Confidentiality Chapter 5

2. Defamation • De-Fame: to take away fame or reputation • An intentional false or defamatory statement about another person that results in damages.

3. Defamation- Legal Elements 1) Intentional 2) False or defamatory 3) Of another person 4) Causing damages

4. Defamation • Libel: The communication of a false or defamatory statement that is written or seen. • Slander: The communication of a false or defamatory statement that is spoken or heard.

5. Invasion of Privacy • “Invasion of privacy” consist in the intentional prying or intruding into another person’s privacy that causes damage. • Legal Elements 1) Intentional 2) Prying or intruding into 3) Another person’s privacy 4) Causing damage

6. Health Insurance Portability and Accountability (HIPAA) • HIPAA 1. Billing 2. Privacy 3. Security

7. HIPAA • The initial motivation for HIPAA was directly connected to the growing use of communication technology and the security problems raised by this technology. • Digital files and information is much easier to copy and pass from user to user. This, of course, is one of its great advantages, but it also raises very serious security issues.

8. HIPAA • HIPAA has two parts: (1) laws that regulate health insurance portability, and (2) laws that regulate health accountability.

9. HIPPA: Laws That Regulate Health Insurance Portability • One of the most important things HIPPA did had to do with health insurance portability. • Before HIPPA an employer’s health insurance could deny coverage of new employee's pre-existing condition. This made it difficult for employees who had any kind of serious medical condition to accept new employment. • Health Insurance portability essentially disallowed health insurance companies to deny coverage of preexisting conditions of new employee.

10. HIPAA: Laws that Regulate Health Accountability • The most popular part of HIPAA is the accountability part that covers privacy and confidentiality. • Electronic exchange of information • Verbal exchange of information • Written exchange of information

11. Who Does HIPAA Apply To? • HIPPA applies to healthcare providers, health insurance companies, and health related companies that receive health patient information.

12. What HIPAA Enforces? • Privacy Rule: “to ensure that individual's health information is properly protected while allowing the flow of health information needed to provide and promote high quality care and to protect the public's health and well being.”

13. What Information is Private? Any information that can single out a person is private and considered Protected Health Information PHI. 1) Names 2) Geographic Information 3) All Dates that directly relate to an individual, such as a date of birth or dates that services were provided. 4) Telephone numbers, including fax numbers, and cell phones numbers. 5) E-mails address 6) Social Security numbers 7) Account numbers, which includes medical record numbers or health plan (insurance) numbers 8) Certificate or license numbers. 9) We site addresses, URL’s or http addresses 10) Biometric identifiers, including fingerprints and voice prints 11) Photographic and comparable images.

14. Legal Disclosures HIPAA permits disclosure of Personal Health Information for the following reasons: • To coordinate treatment and care • To ensure that healthcare workers provide care • To inform family, friends, relatives, or others designated by the patient (unless the patient objects) • To pay health providers • To protect the public health • To make required reporting to governmental agencies

15. How Information is Disclosed • The central principles that should guide healthcare providers in releasing PHI is to give the minimal amount of PHI. • Essentially this means that the healthcare provider should only give the PHI that is required. The information that is not required should be blacked out. • We should distinguish between the original medical document and a copy. We can modify a medical record document of it is a copy. • This process is called de-identify and the resulting modified medical record copy is called the limited data set.

16. Incidental Disclosures • There can arise special cases (exceptions to HIPAA) in which a healthcare provider is justified in disclosing PHI. • For instance, in cases of life or death emergencies, a healthcare provider might be permitted to disclose a patient’s private information. • Imagine someone having a cardiac arrest and a nurse having to scream out PHI in front of other healthcare providers who are not treating the patient.

17. HIPAA Penalties • The US Department of Health and Human Services oversees HIPAA • HHS has joined with Office of Civil Rights OCR and and the Department of Justice DOJ to ensure that individuals are covered and entities are in compliance. • OCR investigates HIPAA complaints because privacy is part of a citizens civil rights.

18. HIPPA • HIPA Training • http://www.youtube.com/watch?v=d2Cw0ARJVDM • HIPAA Changes • http://www.youtube.com/watch?v=UK4uqD2kd4M • HIPAA Administrative Simplification • http://www.youtube.com/watch?v=ahEW1xEKz0Y