The Health Insurance Portability and Accountability Act (HIPAA) does not protect all health information. Nor does it apply to every person who may see or use health information. Show
HIPAA applies to covered entities, business associates and their subcontractors. Covered Entities Health Care Providers Health care providers get paid to provide health care. They include
Health care providers must comply with HIPAA only if they transmit health information electronically in connection with covered transactions. Most providers transmit information electronically to carry out functions such as processing claims and receiving payment and are required to comply with HIPAA. Health Plans Health plans pay the cost of medical care. They include
Health Care Clearinghouses Health care clearinghouses process information so that it can be transmitted in a standard format between covered entities. They often act as a go between for health care providers and health plans which means that they rarely deal directly with patients (e.g. may take information from a doctor and put it into a standard coded format that can be used for insurance purposes).1 Business Associates A business associate creates, receives, maintains or transmits protected health information on behalf of a covered entity or another business associate acting as a subcontractor.2 Services Business associates can perform many different services. Business associates often perform services that do not involve patient interaction including
A common example of a business associate with whom patients may interact is a company that offers a personal health record to individuals on behalf of a covered entity. Responsibilities Covered entities must execute written contracts with their business associates to make sure they safeguard protected health information according to HIPAA standards. Business associates must do the same with any of their subcontractors who can be considered their business associates.3 The Department of Health and Human Services (HHS) website contains more information on business associate relationships and also provides sample language for business associate agreements.4 Business associates must comply with their contractual obligations to covered entities. In addition, business associates are directly liable for violations of the HIPAA Security Rule and many provisions of the HIPAA Privacy Rule—meaning that they are subject to most of the same privacy and data security standards that apply to covered entities and may be subject to HHS audits and penalties.5 Subcontractors Subcontractors that create, maintain or transmit protected health information on behalf of a business associate have the same legal responsibilities as a business associate under HIPAA—meaning privacy- and security-related legal responsibilities flow downstream to subcontractors performing work for a business associate.6 For example, a hospital’s business associate may hire an outside company to shred documents containing protected health information. The outside company (subcontractor) would be required to comply with most HIPAA rules as a business associate and would also be bound by a contract with the business associate rather than the covered entity (hospital). Hybrid Entities Hybrid entities performs both HIPAA-covered and non-covered functions as part of its business. A few examples are
When an organization elects to be treated as a hybrid entity, only the portion of the company that is a covered entity (called the health care component) is subject to HIPAA. Hybrid entities must ensure that the health care component does not disclose protected health information to another non-covered component of the business and must also safeguard electronic protected health information.7 The HIPAA Privacy Rule applies to protected health information, and the HIPAA Security Rule applies to electronic protected health information.8 Health Information Health information is any information (including genetic information) that is created or received by a
and relates to
Health information can exist in any form or medium including paper, electronic or oral. Protected Health Information Protected health information is individually identifiable health information that is held or transmitted by a covered entity or its business associate. Individually identifiable health information identifies—or can be used to identify—a person. It includes demographic and other information that identifies a person such as
Information Not Covered Health Information in Employment Records HIPAA does not apply to health information in employment records. This includes a covered entity’s employment records.11 Most Health Information in Education Records Health information in education records that are subject to the Family Educational Rights and Privacy Act (FERPA) is not considered protected health information under HIPAA.12 Health Information Regarding a Person Who Has Been Deceased for More Than 50 Years For more information on the health information of deceased individuals, see the HHS website’s resource.13 De-Identified Health Information De-identified health information has either had 18 types of identifiers removed or been the subject of an expert determination that there is a very small risk that information could identify an individual. De-identified data is often the subject of debate because of the possibility of re-identifying an individual.14 What are the 4 main purposes of HIPAA?The HIPAA legislation had four primary objectives:
Assure health insurance portability by eliminating job-lock due to pre-existing medical conditions. Reduce healthcare fraud and abuse. Enforce standards for health information. Guarantee security and privacy of health information.
What is the main purpose of the Health Insurance Portability and Accountability Act quizlet?The Health Insurance Portability and Accountability Act of 1996 (HIPAA) had two primary purposes best described as: ensuring that workers could maintain uninterrupted health insurance as they lost or changed jobs and protecting the privacy of personal health information.
What are the main three rules of the Health Insurance Portability and Accountability Act HIPAA?The Health Insurance Portability and Accountability Act (HIPAA) lays out three rules for protecting patient health information, namely: The Privacy Rule. The Security Rule. The Breach Notification Rule.
What are the components of the Health Insurance Portability and Accountability Act?There are four parts to HIPAA's Administrative Simplification: Electronic transactions and code sets standards requirements. Privacy requirements. Security requirements.
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What does the health insurance portability and accountability act do
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