Health Insurance Portability and Accountability Act (HIPAA) refers to a set of comprehensive rules enacted in 1996. The Act has two sections; Title I which provides for access to healthcare, portability and renewability while Title II deals with prevention of healthcare fraud and abuse. The first section (Title I) ensures that employees, as well as their families, have access to affordable healthcare when they change or lose jobs. On the other hand, title II deals with protection of a patient’s healthcare information. HIPPA requires healthcare providers to develop and follow procedures for maintaining confidentiality of a patient’s health information. This applies during sharing, receiving, transferring and handling of such information.
The primary goals of the Act include standardizing insurance claims processing and simplifying administrative functions thus tremendously reducing costs. The most serious concerns addressed by the Act include privacy, security and transaction sets. For example, HIPAA has a privacy rule that protects an individual’s medical records as well as other health related information. This is crucial especially when dealing with patients suffering from chronic illnesses concerned about who has access to their medical information. This also safeguards against the use of medical information for hiring, firing or promotion reasons without the patient’s consent.
Medical assistants, as well as billing specialists, have a critical role to play in safeguarding the patient’s health Information. They have the responsibility of safeguarding a client’s medical information. Both medical assistants and billing specialists have access to information which clients reveal such information to physicians in confidence. Therefore, it is vital to ensure that they store, use and share that information to authorized personnel only. For example, the data can only be viewed and obtained by the authorized staff. It is their responsibility to maintain and ensure the integrity of the contents. HIPPA addresses such public concerns for privacy and security of protected health information under the privacy rule.
Billing specialist and administrative assistants come across confidential patient medical information in the course of their duty. Training and a clear understanding of the privacy rules are essential in ensuring that such information does not land into “wrong hands”. This can only be attained by adopting the guidelines for storing and transmitting protected health information (PHI). They must ensure that such information is protected against public disclosure. Failure to do so amounts to a contravention of the rules which is a punishable offence under the law.
Mistreatment of PHI is accompanied by civil and criminal penalties when presented in a court of law. The department of health and human services (DHHS) determines the nature and extent of the infringement, and the penalty to be administered. The penalties apply to both health care providers (under the corporate criminal liability), and individuals.
Under the HIPAA, employees who obtain or disclose PHI can be fined upto $ 50,000 or face imprisonment for a period of one year. In some circumstances both penalties maybe inflicted on the offender. Workers who “knowingly” disclose the information may face a sentence of five years or pay a charge of $ 100,000 or both. The punishment is more for those who sell the PHI as they may be imprisoned for upto ten years, face a fine of $ 250,000 or face both penalties. Civil penalties also apply for violating the HIPAA. However, exclusion applies to Medicare organizations, who may have committed such for the period before October, 2003. The office of civil rights(within DHSS) ensures that privacy standards are met while the centers for Medicare and Medicaid ensures the enforcement of the transaction and code set standards as well as security standards.
Bibliography
Carole Krager, D. K. (2008). HIPAA for Health Care Professionals. Stamford: Cengage Learning.
Sullivan, J. M. (2004). Hipaa: A Practical Guide to the Privacy And Security of Health Data. Chicago, IL: American Bar Association.
