quizlet the health insurance portability and accountability act

The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule and federal civil rights laws protect Americans' fundamental health rights. The Health Insurance Portability and Accountability Act of 1996 (HIPAA; Kennedy-Kassebaum Act, or Kassebaum-Kennedy Act) consists of 5 Titles. Required Disclosures. Health plans also include employer-sponsored group health plans, government and church-sponsored health plans, and multi-employer health plans. Covered entities must establish and implement policies and procedures (which may be standard protocols) for routine, recurring disclosures, or requests for disclosures, that limits the protected health information disclosed to that which is the minimum amount reasonably necessary to achieve the purpose of the disclosure. caitlinblake . Data Safeguards. 164.502(a)(2).18 45 C.F.R. Covered entities may also disclose to law enforcement if the information is needed to identify or apprehend an escapee or violent criminal.40, Essential Government Functions. HIPAA is important because, due to the passage of the Health Insurance Portability and Accountability Act, the Department of Health and Human Services was able to develop standards that protect the privacy of individually identifiable health information and the confidentiality, integrity, and availability of electronic Protected Health Information. HIPAA is the Health Insurance Portability and Accountability Act, which sets a standard for patient data protection. 21, 1996 110 STAT. The notice must describe the ways in which the covered entity may use and disclose protected health information.

Psychotherapy notes excludes medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date.45 C.F.R. Has as its principal purpose the regulation of the manufacture, registration, distribution, dispensing, or other control of any controlled substances (as defined in 21 U.S.C. The Standards for Privacy of Individually Identifiable Health Information (Privacy Rule) establishes a set of national standards for the use and disclosure of an individual's health information called protected health information by covered entities, as well as standards for providing individuals with privacy rights to understand and control how their health information is used. Preemption. code; (iii) Telephone numbers; (iv) Fax numbers; (v) Electronic mail addresses: (vi) Social Criminal Penalties. Those plans that provide health benefits through a mix of purchased insurance and self-insurance should combine proxy measures to determine their total annual receipts. To comply with the HIPAA Security Rule, all covered entities must: Covered entities should rely on professional ethics and best judgment when considering requests for these permissive uses and disclosures. The Privacy Rule requires a covered entity to treat a "personal representative" the same as the individual, with respect to uses and disclosures of the individual's protected health information, as well as the individual's rights under the Rule.84 A personal representative is a person legally authorized to make health care decisions on an individual's behalf or to act for a deceased individual or the estate. For more information, visit HHSsHIPAA website. See our Combined Regulation Text of All Rules section of our site for the full suite of HIPAAAdministrative Simplification Regulations and Understanding HIPAA for additional guidance material. These penalty provisions are explained below. Yes, it's the "Health Insurance Portability and Accountability Act" we're talking about. Any covered entity may condition compliance with a confidential communication request on the individual specifying an alternative address or method of contact and explaining how any payment will be handled. Common ownership exists if an entity possesses an ownership or equity interest of five percent or more in another entity; common control exists if an entity has the direct or indirect power significantly to influence or direct the actions or policies of another entity.

164.514(e). Covered entities may disclose protected health information to funeral directors as needed, and to coroners or medical examiners to identify a deceased person, determine the cause of death, and perform other functions authorized by law.35, Cadaveric Organ, Eye, or Tissue Donation. Disclosure Accounting. A health plan must distribute its privacy practices notice to each of its enrollees by its Privacy Rule compliance date. 164.512(g).36 45 C.F.R. False: a consumer not a customer Under the Health Insurance Portability and Accountability Act (HIPAA), a security incident is any impermissible use or disclosure of unsecured PHI that harms its . 164.530(h).75 45 C.F.R. 164.512(l).43 45 C.F.R. Enrollment or disenrollment information with respect to the group health plan or a health insurer or HMO offered by the plan. following direct identifiers of the individual or of relatives, employers, or household members of An authorization for marketing that involves the covered entity's receipt of direct or indirect remuneration from a third party must reveal that fact. Question: The Health Insurance Portability and Accountability Act (HIPAA) requires a. employers with more than 50 employees provide medical insurance for all full-time employees. ", Serious Threat to Health or Safety. Covered entities may disclose protected health information as authorized by, and to comply with, workers' compensation laws and other similar programs providing benefits for work-related injuries or illnesses.42 See additional guidance on Workers' Compensation. Therefore, in most cases, parents can exercise individual rights, such as access to the medical record, on behalf of their minor children. A clinically-integrated setting where individuals typically receive health care from more. 160.102, 160.103; see Social Security Act 1172(a)(3), 42 U.S.C. An authorization must be written in specific terms. Covered entities may disclose protected health information to: (1) public health authorities authorized by law to collect or receive such information for preventing or controlling disease, injury, or disability and to public health or other government authorities authorized to receive reports of child abuse and neglect; (2) entities subject to FDA regulation regarding FDA regulated products or activities for purposes such as adverse event reporting, tracking of products, product recalls, and post-marketing surveillance; (3) individuals who may have contracted or been exposed to a communicable disease when notification is authorized by law; and (4) employers, regarding employees, when requested by employers, for information concerning a work-related illness or injury or workplace related medical surveillance, because such information is needed by the employer to comply with the Occupational Safety and Health Administration (OHSA), the Mine Safety and Health Administration (MHSA), or similar state law.30 See additional guidance on Public Health Activities and CDC's web pages on Public Health and HIPAA Guidance. including license plate numbers; (xii) Device identifiers and serial numbers; (xiii) Web Universal A limited data set is protected health information from which certain specified direct identifiers of individuals and their relatives, household members, and employers have been removed.43 A limited data set may be used and disclosed for research, health care operations, and public health purposes, provided the recipient enters into a data use agreement promising specified safeguards for the protected health information within the limited data set. HIPAA Enforcement. In such instances, only certain provisions of the Privacy Rule are applicable to the health care clearinghouse's uses and disclosures of protected health information.8 Health care clearinghouses include billing services, repricing companies, community health management information systems, and value-added networks and switches if these entities perform clearinghouse functions. Covered entities may disclose protected health information in a judicial or administrative proceeding if the request for the information is through an order from a court or administrative tribunal. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Similarly, a covered entity may rely on an individual's informal permission to use or disclose protected health information for the purpose of notifying (including identifying or locating) family members, personal representatives, or others responsible for the individual's care of the individual's location, general condition, or death. 1320d-5.89 Pub. The Privacy Rule permits important uses of information while protecting the privacy of people who seek care and healing. 164.501.23 45 C.F.R. 16 terms. 164.103.80 The Privacy Rule at 45 C.F.R. Members of the clergy are not required to ask for the individual by name when inquiring about patient religious affiliation. Which, if any, of the sample sizes in parts (a), (b), and (c) would . Payment encompasses activities of a health plan to obtain premiums, determine or fulfill responsibilities for coverage and provision of benefits, and furnish or obtain reimbursement for health care delivered to an individual21 and activities of a health care provider to obtain payment or be reimbursed for the provision of health care to an individual. (1) To the Individual. The Department of Health and Human Services, Office for Civil Rights (OCR) is responsible for administering and enforcing these standards and may conduct complaint investigations and compliance reviews. Except in certain circumstances, individuals have the right to review and obtain a copy of their protected health information in a covered entity's designated record set.55 The "designated record set" is that group of records maintained by or for a covered entity that is used, in whole or part, to make decisions about individuals, or that is a provider's medical and billing records about individuals or a health plan's enrollment, payment, claims adjudication, and case or medical management record systems.56 The Rule excepts from the right of access the following protected health information: psychotherapy notes, information compiled for legal proceedings, laboratory results to which the Clinical Laboratory Improvement Act (CLIA) prohibits access, or information held by certain research laboratories. The Privacy Rule calls this information "protected health information (PHI)."12. Guaranteed renewability of . Resource Locators (URLs); (xiv) Internet Protocol (IP) address numbers; (xv) Biometric After making this designation, most of the requirements of the Privacy Rule will apply only to the health care components. This information is called electronic protected health information, or e-PHI. 164.530(i).65 45 C.F.R. In the business associate contract, a covered entity must impose specified written safeguards on the individually identifiable health information used or disclosed by its business associates.10 Moreover, a covered entity may not contractually authorize its business associate to make any use or disclosure of protected health information that would violate the Rule. 164.524.56 45 C.F.R. Privacy Practices Notice. 164.502(e), 164.504(e).11 45 C.F.R. 160.10314 45 C.F.R. 164.504(g).83 45 C.F.R. These individuals and organizations are called covered entities.. Access. 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