Health Insurance Portability and Accountability Act

1. Health Insurance Portability and Accountability Act By Bradley Gleich

2. Pre-HIPAA • Over 400 different insurance forms • System to System differences • ‘Professionalism’ • Lack of Audits • Lack of Protection

3. 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

4. Title II: Administrative Requirements • EDI/Code standardization • ICD-9/10 • CPT-4 • NDC • HLC • Insurance Claim Reform • Form Simplification • Form Reduction

5. Title II: Privacy Requirements • Protected Healthcare Information (PHI) • Any information that can identify the patient • “Need to Know” • Patient’s right to know medical record • Patient’s right to correct medical record • Patient’s right to know how record used

6. 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

7. Title II: Security Requirements • Technical Safeguards • Passwords • Data Encryption • Data integrity – NO RE-WRITE or DELETE • Network Security • Rights Management

8. 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

9. 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