Wikipedia defines health insurance as “insurance against the risk of incurring medical expenses among individuals.

1. Achieve and Maintain Security and Compliance for HIPAA and HITECH
Wikipedia defines health insurance as “insurance against the risk of incurring medical expenses
among individuals.” It meant the same a few decades back when the health insurance industry
comprised of companies that believed in serving people without any monetary gain or personal
benefit. However, today the healthcare industry is a money-spinning profit machine for most of the
health insurance companies, pharmaceutical corporations, lawyers and medical practitioners. As per
Plunkett Research, the leading provider of industry sector analysis & research, industry trends and
industry statistics, the total U.S. health care expenditures were estimated to be $2.9 trillion in 2013,
and are projected to soar to $3.4 trillion in 2016.
Today healthcare practitioners and providers engage in various fraudulent scams and schemes to
defraud the healthcare system. This includes, billing for services not rendered, excessive services,
unnecessary services, kickbacks, duplicate claims, upcoding of services/items, and unbundling. With
patients being on the receiving end, the federal government decided to act tough and enacted the
Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology
for Economic and Clinical Health (HITECH) act to improve the efficiency and effectiveness of the
nation's health care system.
As part of these acts, it was made mandatory that all doctors, dentists, chiropractors, nurses,
psychologists and other professionals including Business Associates that handle Patient Health
Information (PHI) to achieve and maintain security and HIPAA compliance management and HITECH.
Though the federal government has adopted a carrot and stick approach to ensure regulatory
compliance, individuals and corporate entities face various compliance challenges that include:
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Building and proving Security and compliance for review by auditors.
Managing written agreements and proof-of-compliance from all Business Associates and
subcontractors with access to PHI.
Managing 382 controls under HIPAA/HITECH.
Ensuring continuous security and compliance.
The best means to overcome these challenges is to implement an IT compliance management
program. A best of the breed integrated security and compliance management solution
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Supports multiple compliance assessments with harmonized controls.
Provides ready-to-use compliance controls in HIPAA/HITECH, PCI DSS, ISO 27K, FISMA, and
SOX.
Facilitates setting up security controls under different regulations and standards.
Provides free, inline policies and best practices.
Facilitates Meaningful Use reporting.
Meets annual risk assessment requirements mandated by many regulations/standards such
as HIPAA/HITECH and PCI DSS.
Exceeds Stage 1 requirements for the Security Risk Analysis required to demonstrate EMR
Meaningful Use to help secure federal EMR grants.
With some medical practitioners and providers trying hard to tarnish the image of the medical
profession, IT Compliance Management solutions help to keep them in check.
Check out - HITECH compliance