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Data Mining the Mother Lode Legal and Regulatory Issues in Health Information Technology

When you say the teacup is empty Always ask, . Always ask, Empty of what? --Zen Philosophy . 3. Data Mining the Mother Lode. Fundamental Legal Issues Governing Health Information TechnologyPrivacy/SecurityLiabilityMedical ManagementCost/Restrictions. 4. Privacy/Security. HIPAAMedicar

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Data Mining the Mother Lode Legal and Regulatory Issues in Health Information Technology

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    1. Data Mining the Mother Lode Legal and Regulatory Issues in Health Information Technology Capitol Hill Steering Committee on Telehealth and Healthcare Informatics April 26, 2006

    2. When you say the teacup is empty Always ask, Always ask, Empty of what? --Zen Philosophy

    3. 3 Data Mining the Mother Lode Fundamental Legal Issues Governing Health Information Technology Privacy/Security Liability Medical Management Cost/Restrictions   

    4. 4 Privacy/Security HIPAA Medicare and Medicaid Federal and State Drug and Alcohol Laws HIV Information Mental Health Records   

    5. 5 Privacy/Security HIPAA Privacy Rules Facilitate Transmission of Data for Treatment More Limited for Payment and Operations Security – Consistency with Current Standards   

    6. 6 Data Mining the Mother Lode Health Care Legal Presumptions: Vaccination > Opt Out Organ donation > Opt In Fluoridation of Water > No Option

    7. 7 Privacy/Security HIPAA Disclosures/Tracking and Responding to Requests Public Health Public Protection/Law Enforcement Subpoenas Patient Requests Tracking

    8. 8 Privacy/Security HIPAA Security Administrative, Physical and Technical Safeguards Audit Controls Access Controls Authentication Certification   

    9. 9 Privacy/Security Medicare Medicaid Federal and State Drug and Alcohol Laws HIV Information Mental Health Records

    10. 10 Liability Key Issues: Content Practice Enhancements/Evidence Based Medicine UM/DM/CM Pay for Performance Duty to Consult Fraud and Abuse Implications   

    11. 11 Liability Content: Origination Quality/Accuracy/Integrity Amendments/Additions/ Disputations

    12. 12 Liability Practice Enhancements Evidence Based Medicine Pay for Performance Vehicle for Care Management Disease Management Case Management Utilization Management

    13. 13 Liability Duty to Consult: Yes: Primus v. Galgano No: Suniga v. Eyre Susnis v. Radfar

    14. 14 Liability But Innovation Leads to Higher Expectations Consider: Helling v. Carey (Glaucoma Testing) Shannon v. Mc Nulty (Nurse Call Center) Fetal Monitoring Cases X-Ray Cases

    15. 15 What is Medical Management?

    16. 16

    17. 17 Cost Reimbursement Restrictions Stark Anti-kickback Data Mining the Mother Lode ..

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