Wednesday, June 15, 2022

Does Hipaa Allow Continuity Of Health Insurance

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Mental Health Center Corrects Process For Providing Notice Of Privacy Practices

Privacy and Security Rules | HIPAA Training

A mans daughter was not given a written notice of privacy policies before undergoing her mental health evaluation. After a thorough OCR investigation, the mental health center admitted to not giving the patient a written privacy notice before performing the evaluation. To correct the error, the center began implementing new guidelines that changed the way in which patients get booked. From that point on, staff must obtain the patients signature, confirming that the patient received a receipt of the privacy disclosure statement. Some of the companys policies were changed as well.

What Does Hitech Have To Do With Healthcare

HITECH is the acronym behind the Health Information Technology for Economic and Clinical Health Act of 2009. The legislation, signed into law by President Obama on February 17, was intended to accelerate the transition to electronic health records . It was actually included within the American Recovery and Reinvestment Act of 2009 , which was geared toward stimulating the economy.

Another result of HITECH has to do with the Ofce of the National Coordinator for Health Information Technology , which has been part of the HHS Department since 2004. The ONC became responsible for the administration and creation of standards related to HITECH.

The HITECH law is geared more toward the adoption of electronic health records rather than toward specic security rules for digital data. Many HIPAA hosting providers and similar entities are certied for compliance with both HITECH and HIPAA to demonstrate their knowledge of all federal healthcare law.

As you can imagine, there is an overlap between HIPAA and HITECH laws. However, HITECH serves as something of an addendum to HIPAA. It mandates that any standards for technology arising from HITECH must meet the HIPAA Privacy and Security Rules.

How Can Covered Entities Calculate The Limited Fee That Can Be Charged To Individuals To Provide Them With A Copy Of Their Phi

The HIPAA Privacy Rule permits a covered entity to charge a reasonable, cost-based fee for individuals to receive a copy of the individuals PHI. In addition to being reasonable, the fee may include only certain labor, supply, and postage costs that may apply in providing the individual with the copy in the form and format and manner requested or agreed to by the individual. The following methods may be used, as specified below, to calculate this fee.

  • Flat fee for electronic copies of PHI maintained electronically. A covered entity may charge individuals a flat fee for all requests for electronic copies of PHI maintained electronically, provided the fee does not exceed $6.50, inclusive of all labor, supplies, and any applicable postage. Charging a flat fee not to exceed $6.50 is therefore an option for entities that do not want to go through the process of calculating actual or average allowable costs for requests for electronic copies of PHI maintained electronically.
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    Risks To Texting Protective Health Information

    Texting includes use of any service or application to transmit electronic messages between two or more parties. Today, text messages can also include images, sound, and video. There are a number of risks associated with texting protected health information. When a text message is sent to a recipient, there is no definitive way to know that the correct person read the message. Without being able to authenticate the recipient of the message, that individuals protected health information is put at risk, therefore putting the sender in danger of violating HIPAA. This is where HIPAA Compliant Texting Applications have a lot to offer to the professional healthcare community.

    Medical Information Uses And Disclosures: Basics

    Main Goal Of Health Insurance Portability &  Accountability Act (HIPAA)

    The HIPAA Privacy Rule provides individuals with control over if, how, and when their protected health information is used or disclosed for marketing purposes. Pursuant to HIPAA, a covered entity shall not use or disclose a patients protected health information for marketing purposes unless HIPAA permits it or the patient authorizes it in writing. However, this rule is not as simple as it appears to be. There are several prohibitions, limitations, allowances, exceptions, and nuances to the HIPAA regulation.

    It is important that a covered entity understand the differences between marketing communications and communications about goods, treatment, and other health care services.

    So what is marketing? HIPAA defines marketing as making a communication about a product or service that encourages recipients of the communication to purchase or use the product or service. Typically, if the communication is a marketing communication, the covered entity must obtain an individuals authorization.

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    The Law Firm’s Role In Hipaa Compliance

    Law firms are commonly asked to help covered entities and business associates assess their compliance with HIPAA’s privacy, security, and breach notification requirements. This review may occur in the context of an ongoing enforcement action between HHS and a covered entity, or as a covered entity’s preventive self-audit to reduce the risk of an impermissible disclosure. In recent years, HHS has emphasized the need for enterprise-wide HIPAA risk analyses of privacy and security risks and vulnerabilities. Regarding HIPAA’s security rules, for example, this process may include identifying and creating an inventory of all electronic equipment and data systems that use electronic PHI. In response to the risk assessment, a law firm may be asked to help the covered entity or business associate:

    • Develop a risk management plan to address and mitigate any risks uncovered during the risk analysis
    • Review and revise the covered entity’s or business associate’s HIPAA privacy and security policies and procedures
    • Establish and periodically update training materials for all employees and other workforce members
    • Develop procedures to terminate access to PHI when employees and other workforce members leave employment

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    Title Ii: Preventing Health Care Fraud And Abuse Administrative Simplification Medical Liability Reform

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    Title II of HIPAA establishes policies and procedures for maintaining the privacy and the security of individually identifiable health information, outlines numerous offenses relating to health care, and establishes civil and criminal penalties for violations. It also creates several programs to control fraud and abuse within the health-care system. However, the most significant provisions of Title II are its Administrative Simplification rules. Title II requires the Department of Health and Human Services to increase the efficiency of the health-care system by creating standards for the use and dissemination of health-care information.

    These rules apply to “covered entities”, as defined by HIPAA and the HHS. Covered entities include health plans, health care clearinghouses , and health care providers that transmit health care data in a way regulated by HIPAA.

    Per the requirements of Title II, the HHS has promulgated five rules regarding Administrative Simplification: the Privacy Rule, the Transactions and Code Sets Rule, the Security Rule, the Unique Identifiers Rule, and the Enforcement Rule.

    Privacy Rule

    The HIPAA Privacy Rule is composed of national regulations for the use and disclosure of Protected Health Information in healthcare treatment, payment and operations by covered entities.

    2013 Final Omnibus Rule update
    HITECH Act: privacy requirements
    Right to access one’s PHI
    Disclosure to relatives

    Security Rule

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    How Important Is It To Remain Covered Between Jobs

    If youre moving to a different job or even if youve recently lost one, you must make sure that your health insurance coverage does not lapse. This way, youll be able to avoid the many difficulties that usually come with a lapse in coverage. Avoiding a lapse is important for a number of reasons, including the following:

  • Paying out-of-pocket for medical costs can cause a major financial burden. This can be tough to recover from if youre between jobs. Without coverage, youll likely end up paying far more out-of-pocket than you would with coverage.
  • Medical events that happen while youre uninsured may not be covered on your new employee health plan. This is because such events are considered pre-existing conditions.
  • If you have a pre-existing condition, such as diabetes, heart disease, or cancer, you may encounter a pre-existing condition clause in your future policy.
  • You may be nervous about tackling an extra financial burden by taking on a health insurance plan while youre between employee insurance plans. Its important, though, to make sure that you arent putting yourself and your family at greater risk by having no health insurance coverage at all.

    Private Practice Revises Process To Provide Access To Records Regardless Of Payment Source

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    An insurance company requested a patient to be evaluated through a thorough medical exam. However, the practice completely refused to give the patient a copy of their records. OCR, on the other hand, determined the action to be completely compliant with privacy rules. At that point, the company had to change their entire set of guidelines and procedures, giving any patient the right to a copy of their records, regardless of the payment source.

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    Hmo Revises Process To Obtain Valid Authorizations

    HMO sent a patients entire medical record, including PHI, to her disability insurance company. Understandably, this patient made a big issue and complaint. An OCR investigation determined that the information on the transferred form violated certain privacy guidelines. To compensate for the mistake, HMO created a new set of rules. Not only were the new privacy rules stricter, but they must obtain a patient signature before sending any type of information whatsoever, even if the patient requests it.

    Individual Health Plans And Hipaa

    If your employer decides to drop group health insurance, HIPAA might make it easier to get an individual health insurance policy.

    Under HIPAA, you might be able to buy an individual health plan without the threat of exclusions for pre-existing conditions. In order to do so, you have to qualify as an eligible individual.

    In some states, if you qualify for individual health insurance under HIPAA, any company offering individual health plans in that state must sell you coverage. Your states insurance department can explain the rules.

    To be eligible as an individual under HIPAA, you must:

    • Have at least 18 months of continuous creditable coverage without a gap of more than 63 days.
    • Have been covered under a group health plan, a government health plan or church plan during the most recent period of creditable coverage. If you do not have a creditable coverage certificate, you can talk to the health plan to find out if there are other ways you can prove you had 18 months of coverage.
    • Not be eligible for coverage under a group health plan , Medicare or Medicaid.
    • Not have other health insurance.
    • Have not lost your most recent health coverage due to nonpayment of premiums or fraud .
    • Have elected and exhausted any option for continuation of coverage under COBRA that was available under your prior plan.

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    Hipaa Provides Important Health And Private Information Protections

    Heather Mercer is native to Northwest Ohio and graduated from Loma Linda University with two doctorate degrees . She is currently a professor at Owens Community College, as well as a fact-checker for Verywell Health. She has gained experience in a variety of settings, ranging from corporate wellness and preventive medicine, to mental health, chronic disease, and end-of-life care.

    HIPAA refers to the Health Insurance Portability and Accountability Act, which was signed into law by President Bill Clinton in 1996.

    According to the legislation itself, the stated goal of HIPAA was “to improve portability and continuity of health insurance coverage in the group and individual markets, to combat waste, fraud, and abuse in health insurance and health care delivery, to promote the use of medical savings accounts, to improve access to long-term care services and coverage, to simplify the administration of health insurance, and for other purposes.”

    Although HIPAA is a wide-ranging law that affected many aspects of Americans’ health coverage, it’s often misunderstood as being just about information privacy. That is an important aspect of HIPAA, but there’s a lot more to the law .

    This article will explain what HIPAA does, who it protects, and how those protections have evolved over time.

    Who Is Allowed To View A Patients Medical Information Under Hipaa


    Under HIPAA law, only the patient and his personal representative are legally allowed to access medical records. Healthcare providers may in some cases share the information with other medical practitioners where they deem it necessary to save a patient or specific group of individuals from imminent harm. Also, medical records may be shared with a health plan for payment or other purposes with the explicit consent of patients.

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    Summary Hipaa Consent Requirements

    Under the HIPAA Privacy Rule, covered entities are required to follow specific rules when handling PHI. The use and disclosure of PHI requires certain types of consent including nonverbal consent, or written consent depending on the use case. If you think your information was possibly used or disclosed in an inappropriate manner, the best course of action would be to contact HHS.

    If your company is interested in more information about HIPAA audits, feel free to reach out for more information.

    Also see the following Linford & Cos past blog post for more information:

    Ocr Gets New Director

    In September 2021, 8 months into the Biden administration, Lisa J. Pino was appointed as the new OCR Director, taking over from acting OCR director Robinsue Frohboese who headed the agency since the resignation of Roger Severino in January 2021. In contrast to past directors, Pino has cybersecurity and data breach experience, having served as a senior executive service official and senior counsel in the U.S. Department of Homeland Security . Pinos cybersecurity experience may result in a change to how OCR conducts investigations of data breaches, especially in light of the HIPAA Safe Harbor Law. She will also have to guide OCRs enforcement efforts, taking into consideration the findings of the Fith Circuit Court of Appeals.

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    Understanding Hipaa Compliance For Law Firms

    The acronym HIPAA refers to a federal law called the Health Insurance Portability and Accountability Act of 1996. HIPAA is a term that most people hear about in clinic waiting rooms or hospital front desks, or read about in their health plan documents. Although professionals in the health care industry may have greater familiarity with HIPAA, the law is less understood in the general American business world. In this article, we’ll pull back the curtain on HIPAA compliance by introducing HIPAA’s requirements and the role that law firms may play in advising clients that are HIPAA-covered entities or business associates.

    Hitech And The Breach Notification Rule

    Enforcing HIPAA Administrative Simplification Requirements

    The 2009 establishment of the Health Information Technology for Economic and Clinical Health Act was meant to urge medical authorities to adopt Electronic Health Records and lead to the development of the Meaningful Use incentive program. The first part of Meaningful Use, which was introduced a year later, gave healthcare companies and organizations incentives to store their patients PHI electronically instead of on paper.

    This lead to an expansion of HIPAA Rules to Business Associates and third-party medical industry suppliers. It also resulted in the creation of the Breach Notification Rule, which stated that ePHI breaches that affected more than 500 patients are required to be reported to the Department of Health and Human Services Office for Civil Rights. The rules for ePHI breach reports were expanded in March 2013 under the Final Omnibus Rule.

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    New Hipaa Regulations In 2022

    Posted By HIPAA Journal on Jan 14, 2022

      It has been several years since new HIPAA regulations have been signed into law, but HIPAA changes in 2022 are expected. The last update to the HIPAA Rules was the HIPAA Omnibus Rule in 2013, which introduced new requirements mandated by the Health Information Technology for Economic and Clinical Health Act. OCR issued a Notice of Proposed Rulemaking on December 10, 2020, that proposed a slew of changes to the HIPAA Privacy Rule, and a Final Rule is expected to be issued in 2022 however, no date has yet been provided on when the 2022 HIPAA changes will take effect and become enforceable.

      Over the past few years, new HIPAA regulations under consideration include changes to how substance abuse and mental health information records are protected. As part of efforts to tackle the opioid crisis, the HHS is considering changes to both HIPAA and 42 CFR Part 2 regulations that serve to protect the privacy of substance abuse disorder patients who seek treatment at federally assisted programs to improve the level of care that can be provided.

      How Much Disruption Might The New Hipaa Regulations Create

      This will depend on how many of the proposals are adopted in the Final Rule. If patients are allowed to photograph PHI or the maximum time allowed to respond to patient requests is reduced, this will create significant disruption in terms of developing new policies and procedures, training employees on the new policies and procedures, and monitoring compliance.

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      How Hipaa Helps People With Cancer

      The following information applies to grandfathered plans that existed before September 23, 2010 and were not purchased through the Marketplace. Check with your employer to find out your health care plans start date, to learn if its grandfathered. If it isnt, this section does not apply to you.

      HIPAA includes several parts that may help people with cancer who are under older grandfathered individual health plans.

      • It limits whats considered a pre-existing condition. An employer health plan can exclude a medical condition from coverage only if the person had a gap in coverage longer than 63 days, and also had or was recommended to have treatment or medical advice in the 6 months before enrolling in the plan.
      • It limits the time a new employer plan can exclude the pre-existing condition from being covered. An employer health plan can avoid covering costs of medical care for a pre-existing condition for no more than 12 months after the person is accepted into the plan.
      • It gives certain people the right to buy individual health insurance if no group health plan coverage is available, and the person has exhausted COBRA or other continuation coverage. Certain conditions and time limits must be met.
      • It does not allow employers or their health insurers to discriminate or act unfairly against employees and their dependents based on their health status or genetic information.
      • It guarantees certain people the ability to get or renew individual health insurance coverage.

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