2. Goals of Training
• To increase your knowledge & understanding of what protected health
information (PHI) is in this facility, and what threats may exist to its privacy and
its security
• To enhance your awareness of your role in helping this facility follow HIPAA rules
• To provide information about to whom you can go with questions about privacy,
and about security
• To inform you about your reporting responsibilities when HIPAA violations occur
• To alert you to the possible penalties for violation of HIPAA law for both you and
this facility
• To protect the confidentiality of our consumer's Protected Health Information
(PHI) in support of one of our values -- dignity, self-worth and individual
rights. It's the right thing to do!
• To Understand that this same law also protects you as a consumer of health care.
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3. What is HIPAA?
• Portability: Protects and guarantees health
insurance coverage when an employee changes job
• Accountability: Protects health data integrity,
confidentiality and availability
• Reduces Fraud and Abuse
• Makes fraud prosecution easier
(Medicare/Medicaid)
• Reduces Paperwork
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4. WHY COMPLY WITH HIPAA ?
• Avoid denied and or delayed reimbursements
– DHHS agencies process claims bringing in more than $
550 million in receipts annually.
– Annual Medicaid disbursements totaling more than
$4.6 billion.
• May risk Accreditation. (e.g. Joint Commission on
Accreditation on HealthCare Organizations:
• Public relations and business risk issues
• Benefit from long term healthcare cost reductions
• Impose severe penalties for non-compliance
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5. DEFINITION: PRIVACY
Privacy is the right of an individual to keep
his/her individual health information
from being disclosed.
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6. HIPAA Enforcement Continued
• These penalties apply to oral, paper
and electronic Protected Health
Information (PHI).
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7. QUESTIONS?
• If you are ever in doubt, always ask your
Supervisor or their designee!
• Remember, that person is your first line
of response to privacy questions.
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8. Conclusion
HIPAA - A Health Care Paradigm
• Affects clearinghouses, patients.
• Requires changes to business processes and
applications, staffing plans, facilities and
Information systems applications
• Provides patients with rights
• Shifts power in provider/consumer
relationships
• Introduces new legal liabilities
• Conveys severe civil and criminal penalties
payers, providers, employers, medical
manufacturers, Pharmaceutical companies,
employees
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9. Conclusion Continued…
HIPAA - is not going away
• Healthcare industry wants standardization
• Consumers want health information to be protected
• HIPAA is not an option
• HIPAA is doing business in the “New Millennium”
• Implementation cost is short term
• Operational benefit is long term
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10. References
US Department of Health and Human Services
- www.aspe.os.shhs.gov
Center for Medicare and Medical Aid Services
- www.cms/gov
Workgroup for Electronic Data Interchange (WEDI)
- www.wedi.org
Washington Publishing Company
- www.wpc-edi.com
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