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The Health Insurance Portability and Accountability Act of 1996 (HIPAA) has a profound impact on safety net providers. To help agencies afford expert consultation and provide the opportunity for collaboration, a regional health foundation has created the first model in the nation to bring together safety net providers to work toward implementation of the HIPAA.
The Health Insurance Portability and Accountability Act (HIPAA) requires physicians to place greater responsibility on protecting electronic transfer of medical records to patients and other medical providers, while allowing them greater access to their owned medical records. The required protections on use of electronic medical records will be very costly to the physician's office practice. This paper highlights the HIPAA requirements to protect medical records and assure access to consumers. The new HIPAA provisions will require physicians and managed care plans to develop new safeguards and management procedures to enhance the protection of electronic medical information and data base systems.
This article reviews the issues related to the Health Insurance Portability & Accountability Act (HIPAA) security rule that apply to dental practice. The security rule specifically addresses individually identifiable health information that is transmitted or maintained in electronic media. System security must be applied to the entire technical infrastructure for the practice environment as well as to the work culture on a daily basis and must be thought of as an enterprise asset. Security refers to all of the policies, procedures, tools, and techniques used to assure that privacy and confidentiality are adequately addressed in a healthcare system. HIPAA requires all covered entities that transmit or maintain electronic health information perform, and document, a risk assessment for security and develop a security plan to address major areas of concern. A self-assessment tool is provided in this article.
Health care professionals are faced with ever-changing rules and regulations and technological advances. Add to this the 1996 Health Insurance Portability and Accountability Act (HIPAA) and the health care manager's list of challenges continues to expand. This article presents an overview of HIPAA requirements and tools for use by health care managers in ensuring their facility is in compliance with the latest rulings.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) includes a number of provisions that significantly affect health care plans. This article outlines key aspects of these changes, which apply to all health care plans, including those covering multiemployer, governmental and church groups.
The Health Insurance Portability and Accountability Act (HIPAA) of 1996 has been praised and criticized for asserting federal authority to regulate health insurance. We review the history of federalism and insurance regulation and find that HIPAA is less of a departure from traditional federal authority than it is an application of existing tools to meet evolving health policy goals. This interpretation could clarify future health policy debates about appropriate federal and state responsibilities. We also report on the insurance environments and the HIPAA implementation choices of thirteen states. We conclude with criteria for judging the success of HIPAA and the evolving federal/state partnership in health insurance regulation.
The Health Insurance Portability and Accountability Act contains 11 rules, 6 of which have been released to date. Within each of the rules are numerous actions to be implemented. This article reviews those actions and provides health care managers with what exactly needs to be done to be in compliance with the Health Insurance Portability and Accountability Act effectively and efficiently.
OBJECTIVE: To evaluate the effect of impending HIPAA regulations on Applications for Exemptions from Institutional Review Board (IRB) approval. SUMMARY BACKGROUND DATA: HIPAA was implemented to reduce potential for misuse of personal information and restricts access to medical records by insurers, employers, and clinical researchers. We hypothesized that HIPAA regulations adversely impact medical records research. METHODS: The UW-Madison Human Subjects Committee database was accessed to evaluate success and delays in processing Applications for Exemption between September 1999 and March 2003. The number of protocols submitted, number of required revisions, and number considered nonexempt (requiring full IRB review) were determined. RESULTS: Prior to 2000, applications for medical records research were rare (11 applications in 1999-2000). In anticipation of the implementation of HIPAA regulations, a new application process was instituted in 2001. During that year, 92 of 103 were approved by an expedited process with few requiring full IRB approval. In 2002 to 2003, submissions increased to 199 and approval without revision dropped to 59% (P < 0.0001) as the number requiring revision (25%) and full IRB approval (16%) increased significantly (P < 0.0001 and P < 0.05, respectively). Of the 31 requiring full IRB approval, 7 were pursued while 24 (77%) were abandoned. CONCLUSION: HIPAA appears to inhibit medical record and database research. Ethical considerations in healthcare research are paramount, but current HIPAA implementation strategies increase workload for HSC and researchers, and increase the dropout rate for proposed studies when investigators are unable or unwilling to meet the regulatory requirements. It is unclear whether or to what degree the new requirements add to protection of privacy. Studies designed to investigate the costs and effects on quantity and/or quality of research should be prospectively implemented.
Health information privacy is important in US society, but existing federal and state law does not offer adequate protection. The Department of Health and Human Services, under powers granted by the Health Insurance Portability and Accountability Act of 1996, recently issued a final rule providing systematic, nationwide health information privacy protection. The rule is extensive in its scope, applying to health plans, health care clearinghouses, and health care providers (hospitals, clinics, and health departments) who conduct financial transactions electronically ("covered entities"). The rule applies to personally identifiable information in any form, whether communicated electronically, on paper, or orally. The rule does not preempt state law that affords more stringent privacy protection; thus, the health care industry will have to comply with multiple layers of federal and state law. The rule affords patients rights to education about privacy safeguards, access to their medical records, and a process for correction of records. It also requires the patient's permission for disclosures of personal information. While privacy is an important value, it may conflict with public responsibilities to use data for social goods. The rule has special provisions for disclosure of health information for research, public health, law enforcement, and commercial marketing. The privacy debate will continue in Congress and within the president's administration. The primary focus will be on the costs and burdens on health care providers, the ability of health care professionals to use and share full medical information when treating patients, the provision of patient care in a timely and efficient manner, and parents' access to information about the health of their children.
The Health Insurance Portability and Accountability Act of 1996 may well be the most significant increase ever in the federal government's health care fraud and abuse enforcement authority. This new authority coupled with increased scrutiny of the health care industry generally creates a compelling incentive for health care facilities to develop corporate compliance programs.
The Administrative Simplification Title of the Health Insurance Portability and Accountability Act of 1996 addresses the creation and adoption of nationwide standards for the electronic exchange and confidentiality protection of all individually identified data used in health care administration. The U.S. Department of Health and Human Services (DHHS) is implementing standards under this law. In addition to new standards, the law mandates that the Congress pass a health information privacy bill by August 1999 or that the DHHS adopt privacy protections for health information by February 2000. Published in 2001 by John Wiley & Sons, Ltd.
The Health Insurance Portability and Accountability Act, many provisions of which became effective on January 1, 1997, will have a significant impact in the area of health care fraud and abuse. This article examines the fraud and abuse provisions of the new act from the point of view of the practicing physician. The greatest impact on the health care provider will come from the increased enforcement resources which will be available as a result of the act. The act also contains some particular substantive additions to health care fraud and abuse law which will be applicable to physicians, including provisions penalizing health care fraud, wrongful disclosure of individually identifiable health information, false certification for home care, and false statement to a health benefit program.
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Attorney Rovner presents a very detailed accounting of the impacts of the Health Insurance Portability and Accountability Act as it relates to group health insurance including provisions that concern pre-existing conditions, special enrollment rights, premium discrimination, maternity lengths of stay, parity for mental health benefits and small groups coverage. The article concludes with a discussion of the federalism question as it relates to regulation of private market health financing.
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The Health Insurance Portability and Accountability Act (HIPAA), and its final rule, raised fears among practitioners of new and complex regulations that might interfere with medical practice, lead to inadvertent liability and unwanted expense. It generated a dizzying set of health-care administrative activities and a new work for legal consultants. It has extensive scope, and includes most health plans and practitioners. It has regulated both privacy and security, including electronic, paper, and oral communications. However, after a HIPAA compliant office structure is established, and the privacy notice is reviewed and signed by the patient, disclosure of medical information for treatment, payment or "health-care operations" is permitted without recurrent consent forms, thus allowing substantially familiar patterns of doctor-to-doctor communication about treatment. Further, the initial approach to enforcement appears to some legal observers to be more likely corrective rather than punitive, although providers remain uneasy over the mere possibility of criminal penalties. As regards medical research, uncertainties about the application of HIPAA seem less resolved and more variably interpreted by different institutions, with ongoing fear in the research community that important public health and epidemiologic research activity may be compromised by well meaning IRBs using inconsistent, overly strict or erroneous interpretation of the intent of HIPAA regulations.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA; PL 104-191), popularly known as the Kassebaum-Kennedy legislation, contains a broad array of provisions with collective implications for a large segment of the population. The legislation contains provisions affecting the private insurance markets, the federal tax code, and strategies for decreasing fraud and abuse and for increasing the simplification of administrative procedures. Two objectives hold together the disparate pieces of this legislation. The first objective is to improve the accessibility of insurance for individuals with preexisting medical conditions. The second objective is to make health insurance and health services more affordable. This article is designed to provide an overview of the multiple components of HIPAA, and to identify the parties that are likely to be affected by each component. It concludes with a discussion of how well HIPAA can be expected to fulfill its two goals.