Health Care Privacy and Security Law: Health Insurance Portability and Accountability (HIPAA)
Introduction
Every citizen is required to achieve and maintain privacy and security of healthcare information as stated by the Office of the National Coordinator for Health Information Technology (ONCHIT). It provides resources assisting citizens to succeed in achieving their responsibilities concerning privacy and security of electronic health care data. Thus, electronic health care records concerning data storage and transmittal is a sensitive and serious issue. The Health Insurance Portability and Accountability Act (HIPAA) offers a guide to health care privacy and security. It was enacted on August 1996 encompassing administrative simplification provisions requiring the United States Department of Health and Human Services (HHS) to promulgate the law’s standards. Thus, the law comprehensively analyzes standards and policies providing a better understanding of how to integrate federal health information privacy and security requirements into health care practices. Ultimately, HIPAA promulgates standards regarding storage and exchange of electronic health care records while safeguarding and protecting individuals’ privacy on personal health care information (Kempfert, & Reed, 2011). Focusing on the law of health care privacy and security will affirm that health care entities and business associates ought to comply with HIPAA standards and policies.
Relationship between the Law of Privacy and Security and Policy in Health Care
HIPAA provisions aim to prevent citizens from losing their health care coverage attributed to pre-existing conditions. This mainly occurs when individuals change employers resulting in registration with a new health care plan. HIPAA’s Portability and Tax Provision ensures the number of unemployed and self-employed citizens without health insurance continues to decline. This is achieved by making it easy for affected individuals to acquire health insurance coverage without relying on the employer. It prompted the Administrative Simplification Provision to be established. It instructs Department of Health and Human Services through the Secretary of the United States to issue several regulations concerning transmission of electronic health care information (Taitsman, Grimm, & Agrawal, 2013).
In the early 1990s, the health care entities in the country could not standardize the process allowing the use of electronic information without federal action. As a result, the final version of the HIPAA law asserts that health care plans request federal legislation for the set security standards and regulations to develop nationwide security safeguards concerning using the of electronic health care information. Specific regulations address physical, administrative, and technical security procedures that health care plans and providers ought to address during their operations and practices to prevent unauthorized disclosures, access, and use of private and protected health care information. The provision also ensures standards are developed for unique health identifiers for patients, health plans, providers, and employers to attain privacy and security of health care records (Taitsman, Grimm, & Agrawal, 2013).
For example, Centers for Medicaid and Medicare Services issued standards for unique health care identifiers for providers, health plans, and employers to be developed to safeguard health care information. The provision also mandated the creation of privacy standards to protect and safeguard personally identifiable health care information. The privacy and security of private medical information has been the primary objective of HIPAA. Congress also recognizes advancing electronic technologies can erode the privacy of medical records (Rahman, 2006). As a result, the Privacy Rule constituting broad-ranging federal health privacy regulations incorporates basic fair information practices restricting the disclosure and use of protected health care records. Individual can, however, authorize or permit use their records as provided by the Privacy Rule (Jackson, Fraser, & Ash, 2014).
Legislative vs. Institutional Policies in Relation to Health Care Privacy and Security Law
HIPAA was developed to enhance security and privacy measures implemented to safeguard medical records. The government has implemented policies stimulating quality management among health care organizations. The legislative policies associated with health care impact health care practices applied in treating patients. They also ensure health care providers distribute quality services. Consequently, they help in coordinating national responses to proposed changes in the architectural accessibility of health care services. Legislative policies also ensure patients have accommodating environments when seeking health care services without feeling alienated or prejudiced. As a result, HIPAA strives to ensure health care facilities are held accountable for having resources accommodating and addressing diverse patients’ needs while maintaining, securing and protecting their records (Pritts, Neblo, Damschroder, & Hayward, 2008).
Conversely, institutional policies concerning HIPAA are supplemented by provisions applied to determine how health care records can either be disclosed or used by entities for research purposes. The HIPAA Privacy Rule asserts that health care records should not be created, used or disclosed for research purposes without informing the owners. For example, clinical trials and research relying on specific elements contained in health care records should be retrieved after the individual owners sign a consent form allowing the data to be disclosed and used (Taitsman, Grimm, & Agrawal, 2013).
Agencies providing the medical data are permitted to disclose the information for research purposes without permission if their use and disclosure involve limited data sets. Such agencies are required to enter into a data usage agreement with researchers concerning limited data set safeguarding the health care information excluding direct identifiers of individuals, employers, and households. Consequently, health care records can be freely released if they do not contain individually identifiable information (Koetting, 2001). Thus, institutional policies seek to affirm that, HIPAA safeguards medical records by ensuring individual and group subjects either provide limited data sets or maintain anonymity directly and indirectly.
The Influence of Politics on the Health Care Privacy and Security Law
Political procedures ought to identify with institutional and legislative policies to understand where, how, and who lobbies to achieve goals allied to HIPAA. Five elements ought to be considered in evaluating how politics influence HIPAA namely; consensus, competition, the rule of law, good governance, and inclusion. The consensus element should be considered to determine if a basic agreement on the most fundamental rules of political life influence HIPAA. Thus, the agreement should ensure that citizens and the rules achieving ultimate political power acknowledge that health care records should be private and safeguarded. The element of competition involves evaluating how health care systems are competing. Based on HIPAA, health care systems, agencies, and entities providing services and maintaining health care records should ensure they safeguard them. Thus, they should not use and disclose health care records to win elections. They should also avoid disclosing the records to the media and marketplaces in pursuit of their interests and ideas (Taitsman, Grimm, & Agrawal, 2013).
The element of inclusion and exclusion is applied to determine how politics are influencing health care providers socially, economically, and politically. HIPAA strives to ensure that medical records are safeguarded and protected without focusing on the owners’ ethnicities, religious beliefs, gender, and income status as everyone is entitled to healthcare privacy and security without discrimination. The element of good governance seeks to determine how politics influences public and private health care entities. HIPAA strives to ensure that the state adequately governs public and private health care entities by ensuring they are accountable, transparent and efficient in delivering quality services to patients in line HIPAA. The element of the rule of law refers to basic legal structures for private and public interactions and activities. It guarantees that rule of law does not infringe basic human rights. It also ensures health records are safeguarded and protected for the state to guarantee personal security equitably in line with the HIPAA (Kempfert, & Reed, 2011).
The Role and Impact of Governmental and Non-Governmental Regulatory Agencies on the Health Care Privacy and Security Policy
Governmental and non-governmental agencies play instrumental roles impacting health care laws. Through development, regulation, and implementation of policies, health care law on health care privacy and security is maintained. Policies set by health care law on health care privacy and security is maintained by acknowledging and focusing on the need to protect health care records across national levels. Goals and long-term strategies affecting individuals, families, and organizations, as well as health care providers, are vital in ensuring health care records are safeguarded and protected. HIPAA regulates health care entities by carrying out public policies while creating environments prioritizing on safeguarding health care records. For example, disabled individuals are often taken advantage of. HIPAA has implemented policies ensuring they are accessed and receive health care services across the nation without their health care records being unauthorized released, disclosed, and used especially for medical research purposes (Kempfert, & Reed, 2011).
HIPAA also establishes and allows boundaries and protection of health care records for patients who may not be in a position to make sensible health care demands. The HIPAA regulations are applied in clarifying definitions, eligibilities, benefits, standards, and authorities within the health care industry tasked with maintaining HIPAA. Governmental and non-governmental regulatory agencies are required to allow funding support systems sustaining health and product development research programs. The programs are often publicized as means of awareness and education (Kempfert, & Reed, 2011).
Government’s role in relation HIPAA should be ensuring the cost of services offered to patients do not become expensive due to the need of safeguarding and protecting health care records. The government’s role also involves ensuring health care services are not outsourced to other nations in attempts to reduce the gross domestic product. Conversely, non-government regulatory agencies should collaborate with government entities in implementing and enforcing laws guarantying privacy and security of healthcare records. More so, they should ensure health care services are provided adequately and fairly for all communities in line with HIPAA (Kempfert, & Reed, 2011).
The Impact of Legislative Policy on Resource Allocation in the Health Care Industry
Legislative policies are implemented to provide guidance and information in line with health care laws enforced for patients to access and receive quality services. For example, a legislative policy can be enforced to provide guidance and information on how health care resources ought to be applied across the health care industry. Affordable health care across the United States has been limited due to demand exceeding the supply levels. Specialty care, clinics, and hospitals are established to ensure health care providers including doctors and nurses offer quality services to patients. This, however, has been adversely affected by limiting factors that have led material and human capital to decline (McGowan, 2012).
Resource allocation, on the other hand, has been allowing a larger number of patients to access and receive health care services at various health care facilities in the country. More so, the federal budget has been allocating more financial capital in the health care industry as Affordable Care Act strives to ensure all citizens access health care equitably. However, this has changed the business model in health care as facilities are concentrating on quality of services they offer without focusing on costs associated in upholding HIPAA (Kempfert, & Reed, 2011).
The Role of Organizational Stakeholders and Interest Groups involved in Health Care Laws and Regulations
Stakeholders and interest groups play the role of pushing initiatives of health care laws and regulations. They also challenge for more positive changes concerning health care within communities to be achieved. Stakeholders associated with health care laws include entities within the organization environments playing the role of pushing for improved health care laws and performance levels. They include individuals and groups with vested interests in the health care industry. As a result, they support policies and decisions seeking to improve the quality of health care in the country. Thus, they provide input when devising, passing, and enforcing laws and regulations in line with HIPAA. They strive to ensure quality health care services are accessible and affordable equitably across regions and communities in the country (McGowan, 2012).
However, they also pay special focus on the need to uphold the health care privacy and security law in line with HIPAA. Thus, they strive to affirm medical providers including doctors, nurses, physicians, pharmacists, social workers, and paramedic personnel protect patients’ health care records. They should not disclose patients’ health care records without permission. Ultimately, external and internal stakeholders, as well as interested parties, including medical physicians, insurance companies, pharmaceutical firms and the patients, collaborate in ensuring HIPAA is respected in line with the health care privacy and security law (Kempfert, & Reed, 2011).
In conclusion, the health care privacy and security law concerning HIPAA should be upheld to mitigate the real threats patients face in case their health care records are disclosed and used without their permission. The law also mitigates risks patients can face including losing insurability in case their health care records are disclosed without their permission as this violates their realistically estimations and likelihoods considered as cost benefits by insurance companies. HIPAA notes that privacy and security of healthcare records is not only a right but also an affordable essential medical need.
References
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Kempfert, E. A., & Reed, D. B. (2011). Health care reform in the United States: HITECH Act and HIPAA privacy, security, and enforcement issues. HIPAA Survival Guide.
Koetting, M. (2001). Comments on privacy and medicine. Journal of Legal Studies, 30(2),703-707.
Kumekawa, J. (2005). Overview and summary-HIPAA: How our health care world has changed. The Online Journal of Issues in Nursing, 10(2).
McGowan, C. (2012). Legal issues: Patients’ confidentiality. Critical Care Nurse, 32(5), 61-64.
Pritts, J., Neblo, M., Damschroder, L., & Hayward, R. (2008). Veterans’ views on balancing privacy and research in medicine: A deliberative democratic study, Michigan State University. Journal of Medicine and Law, 12(1), 17–31.
Rahman, N. (2006). Medical: Reflections on privacy - Recent developments in HIPAA Privacy Rule. A Journal of Law and Policy for the Information Society, 2(3), 685.
Taitsman, J., Grimm, C., & Agrawal, S. (2013). Protecting patient privacy and data security. New England Journal of Medicine, 368(11), 977-979.
