Paper Example on Health Insurance Portability and Accountability Act

On August 21, 1996, Congress promulgated the Health Insurance Portability and Accountability Act (HIPAA), which was primarily aimed at delivering health care services with efficacy including augmenting the proportion of Americans with health insurance coverage (Centers for Disease Control and Prevention, 2003). The Privacy Rule was implemented under the administrative provision whereby the Secretary of the U.S Department of Health and Human Services was commissioned to issue set of regulation concerning the digitization of health information, which was fast gaining traction in the 90s. In essence, the conventions targeted the standardization of electronic health information including the potential security risks that endangered the privacy of patient information. Accordingly, the HIPAA framework ensured that nationwide safeguards and security standards were installed while accessing electronic health care information without infringing on the privacy rights of patients.

Benefits of HIPAA

The HIPAA applies to healthcare clearing houses, health plans, and health care providers who transmit information electronically. Under the health plans umbrella, the entities that are covered include group and individual outlines that either pay or provide medical cover. These include health maintenance organizations, Medicare, Medicaid, prescription drug insurers, long-term care insurers, dental and vision health providers. Other plans include church ad government-sponsored group health plans and those that employer-sponsored in nature. Health care clearinghouses refer to bodies which have been sanctioned to convert non-standardized health information into data content (Fedorowicz & Ray, 2004). This implies that such entities have access to individually identifiable health information only when offering services to a health care provider who acts in the capacity of a business associate. In such an instance, certain elements of the Privacy Rule are enforceable in regards to the synthesis health information. Examples of health clearing houses include community health management systems, re-pricing firms, billing services and value-added networks. In essence, every health care provider who interacts with electronic systems in regards to dissemination of health information is catered for regardless of the size of the entity. Some of the transactions that are common include benefit eligibility inquiries; health claims, referral authorization requests, and other dealings instituted by HHS and are accommodated under the HIPAA Transaction Rule.

Objectives and Outcomes of Training

The HIPAA Privacy Rule recommends that training is conducted based on the notion that it is ideal and a requirement as it enables health professionals to carry out their functions with efficacy. Consequently, the magnitude of training varies and is dependent on the relevance of job responsibilities since there is limited interaction in regards to protected health information (PHI). The most commonly trained topics include the familiarization with the minimum necessary rule, the essence of confidentiality, techniques of avoiding snooping and disclosures of PHI (Murray, Calhoun & Philipsen, 2011). Equally important is the fact that authorization and patient rights are some of the dominant topics that are covered including the core information on the obligations towards business associates. Besides, the health personnel ought to be conversant with the consequences of not observing the stipulations of the HIPAA Privacy Rule. This may be achieved through demystifying components such as how trust may be lost, victimization following an identity theft, possible penalization by the HHS including prosecution under the law for the parties involved in the violation of privacy.

HIPAA Security Rule

Technical Safeguards

By the guidelines of the Security Rule, technical safeguards may be defined as the policies and procedures, which have instituted exclusively to protect control and access to health information. One of the key areas of concern in regards to technical safeguards involves the mechanism of regulating access controls where users are provided with privileges to perform their duties using applications, information systems files, or programs. Accordingly, access controls facilitate its users with rights to the least amount necessary information, which is based on a set of defined access rules as determined by an entity. A Unique User Identification and Emergency Access Procedure are mandatory recommendations where the former aids in tracking the users while the latter involves procedures or obtaining information during an emergency such as electrical sabotage (CMS 2007). Another measure may include the development of integrity standards, which protect against altering or illicitly destroying EHPI. This may be achieved through verification of users and the integration of encryption and decryption of health data to ensure that its transmission over communication networks is not compromised.

Physical Safeguards

Physical safeguards may be defined as the measures, which have been enacted with the aim of physically securing information systems and its related equipment from unlawful access and natural or environmental calamities. The initial standard under this module infers to the adoption of policies, which limits the physical access of EPHI in the facilities where it is housed while ensuring only authorized persons are permitted in such areas. Subsequently, this implies that contingency plans ought to be considered if data is lost which is enshrined in the data recovery plan (CMS, 2007). Additionally, validation of access to facilities is limited to the functions of professionals including implementing regulations on visitors as well as access to software programs for purposes of testing and revising them. Security measures may also be achieved through installation of CCTV cameras, alarm systems, and applying processes for documenting modifications and repairs of the physical component in the facility such as locks and hardware.

Administrative Safeguards

Administrative safeguards may be defined as dogmata that are focused on the assortment, expansion, execution, and maintenance of security measures for protecting EPHI including the management of attitudes of the organizations workforce in regards to protecting this information. The first step of this approach would involve the conduction of a risk management and risk assessment, which would be crucial in the prevention, detection, and containment of security breaches. Furthermore, an exhaustive and evidence-based evaluation will aid in identifying the vulnerabilities that threaten integrity, confidentiality, and availability of EHPI. Appropriate sanctions may also be applied to the section of the workforce that is not in compliance with the security protocols established by the organization. In the event of a breach, the health organization may employ mechanisms of modifying the access to transactions, programs, and the workstation by altering the credentials of the now defunct personnel.

HIPAA Privacy Rule

Distinguishing which Information May be Shared

The Privacy Rule protects all independently perceptible health information that may be in possession of a health organization or business associate and may be in the form of oral, electronic or written in the paper. Such information is what comprises the PHI, which describes a patients past, present and future mental or physical health condition including modes of provision of healthcare and the methodologies to be used during payment for services. Common identifiers that may support this cause may encompass an individuals birth date, Social Security number, the name and area of residence. On the other hand, the Privacy Rule excludes de-identified health information, which includes employment records, educational background and selected records in the Family Educational Rights and Privacy Act.

Maintenance of the Integrity of PHI

One of the mechanisms of ensuring the credibility of the PHI is through the implementation of mechanisms that corroborate that the information embedded within the electronic system has not been ruined or altered in an unapproved manner. This may be accomplished through conducting a risk analysis within the entity and implementing the necessary security measure to diminish the identified risks, which may demand the introduction of digital signatures and sum verification techniques. Additionally, proof of identification may be achieved through the creation of password or pin-sensitive access portals including the use of communication protocols.

Obtaining Written Consent from Patients

Organizations ought to get a written authorization from patients in regards to disclosure of PHI that is not meant for purposes of treatment, health care operations or payment. Consequently, the consent should be incorporate specific terms as to the limits of sharing information by the third parties or the organization. Some of the examples of disclosures under certain circumstances include the revelation of information to a life insurer to facilitate coverage, disclosure to a pharmaceutical firm for the intent of marketing an informing an employer who covers costs associated with a pre-employment physical test (Ness & Joint Policy Committee, 2007). Equally important is that elements such as the expiration of the disclosure and the right to revoke in writing should be included in the written consent.

HIPAA Breach Notification Rule

This directive requires that the entities, which are covered, are obliged to inform the HHS, the affected individuals and the media to some extent if a break in the lax PHI occurs. Indeed, most notifications are to be reported within a reasonable time frame and no later than 60 days following the discovery of the compromised system. Smaller security breaches often affecting not more than 500 persons may be filed with the HHS on an annual basis (U.S. Department of Health and Human Services). Moreover, business associates of the affected organizations are also put on notice following a breach of the PHI.

HIPAA Omnibus Rule

Omnibus Rule represents the most recent piece of legislation, which was aimed at filling incongruences existing in HITECH and HIPAA regulations. One of the significant modifications was the expansion of the term workforce,' which now includes the trainees, employees, and volunteers who are attached to a covered entity or a business associate. Encryption standards, which would render data obsolete following a breach, were also developed (U.S. Department of Health and Human Services). Besides, the Privacy Rule was amended to ensure that patient information is held indefinitely unlike the previously recommended fifty years including the current revisions for the penalties to be applied following the violations on EPHI. Amendments to cater for the changing work practices was also developed under this provision which allows healthcare professionals to use their mobile phones to access health information while administrative policies were drawn up to accommodate this phenomenon.

HIPAA Enforcement Rule

The enforcement process involves investigations following complaints, which is conducted by the OCT in conjunction with the DOJ. Some of the penalties for noncompliance include monetary compensation for the damage, and in the event of gross malpractice, criminal violations of the HIPAA which warrant prosecution may be explored accordingly (U.S. Department of Health and Human Services). Moreover, the ensuing risk as...