HIPAA Violations

The penalties for violating the rules dictating by HIPAA are complicated because the guidelines are still very broad and the rules are still so new that with each case new standards are being set as to the way violations are being handled. Violation of HIPAA rules can result in civil and criminal consequences. There is case that marked history as the first health care organization to be fined for a HIPAA violation. Cignet Health in Maryland was fined $4.3 million for two violations: failure to provide patients a copy of their medical records within 60 days of a request and failure to cooperate with civil investigators. “HIPAA calls for civil and criminal penalties for privacy and security violations, including: -- fines up to $25K for multiple violations of the same standard in a calendar year -

All healthcare providers, health organizations, and government health plans that use, store, maintain, or transmit patient health care information are required to comply with the privacy regulations of the HIPAA

Prior to HIPAA becoming a legislation, patient’s medical records was disclosed without their permission to lenders and outside providers from their treatment team. Privacy Rules were not in place to protect patient’s sensitive medical records without providing written or verbal permission. In addition, prior to HIPAA being created patients could potentially be denied employment, housing, or treatment due to reviewing medical records that was unrelated to claim or application for housing, employment, etc.

HIPPA is the law to protect health information communicated in any manner. It states the privacy and security regulations on the rights and standards of the patient. It also defined the penalties for those who fail to protect the individual’s identifiable health information. The information on patient’s name, diagnosis, important activities for the shift and room number are all included in the HIPPA privacy rule. HIPPA privacy rule part § 162.1002 Medical data code sets. (i) Prevention. (ii) Diagnosis. (iii) Treatment. (iv)

The privacy rule applies to personal health information in any form, electronic or paper, which includes the entire medical record. Individuals have full access to their information, can limit who can gain access to his or her records, can request changes to their medical record if there’s any reason they suspect that the information isn't accurate. In addition, the private information shared is kept to the minimal amount needed. Also, the patients have the privilege to decide whether or not to release their protected health information or PHI for purposes unrelated to any treatments or payment issues, such as research project. (Krager & Krager, 2008) HIPAA implemented specific code sets for diagnosis and procedures to be used in all transactions. Covered entities must adhere to the content and format requirements of each standard. (Center for Medicare and Medicaid Services, n.d)The security rule supplements the privacy rule; it deals specifically with electronic PHI or ePHI. It applies to covered entities that transmit health information in electronically. The Security Rule requires covered entities to keep appropriate

In most offices, and outpatient services has a team where the physician is unable to monitor the team at all times. For example, in a pharmacy setting there are pharmacists, pharmacy technicians, and clerks at times. The majority of the time the clerks have the most patient contact where the pharmacists are unable to monitor them at all times making sure protected health information is not spread. In the HIPAA rules, covered entities include health plans, health care clearinghouses, and health care professionals who electronically transmit any health information in connection with transactions for which HHS has adopted standards (Tomes, 2007). In writing, the people who are liable for violations are one those providers who bill electronically are covered entities. Directors or officers can commit violations by selling individually identifiable health information to a drug company for marketing purposes, they can also be charged if the director and or officer aided a covered entity’s commission of the HIPAA criminal act, and lastly can be heavily prosecuted if they commit identity theft utilizing patients protected health information (Tomes,

During this research, there has been a collection of data that had been connected to the instances of HIPAA violations within the United States. There are various cases that have been reported through patients and employees where very personal medical information has been exposed unlawfully for personal gain. These cases have not only put a company at reputational risk. But these cases can also place a patient and or healthcare company in a terrible financial stipulation. This thesis will include a series of charts and tables that describe the fluctuation of such cases involving different examples of HIPAA violations. Not only will there be data of these instances but there will be illustrations of how both patients and healthcare employees exemplify HIPAA violations. These cases will be verified from an external and internal evaluation. Suggestive protocol will be demonstrated to guide one along to ensure the possibility of another case of HIPAA violation is prevented. Protocols and examples are being credited by diverse information.

In any medical office the medical professionals have to be very careful not to violate HIPAA laws. To make sure these violations don't happen the MA needs to make sure that:

Any patient that is seen by a physician within the United States is to be protected by the “Health Insurance Portability and Accountability Act” or HIPAA, which was passed into law in 1996 (Jani, 2009). All health care facilities dealing with any protected health information (PHI) are to ensure that all physical/electronic processes are safeguarded from any third party entity or unauthorized personnel according to HIPAA. All health care data to include any medical insurance

Each policy that has been formulated and brought forth to legislation goes through its many challenges and analyzation before being implemented and becomes a policy and part of legislation. The statutes of HIPAA were brought forth and formulated in hopes of regulating covered entities and providing a type of universal protection of patient information and data. There is no doubt that the policy for HIPAA created skepticism about health privacy laws and the impact that it would have on the health care industry and its professionals.

"HIPAA doesn?t necessarily prescribe the solutions, but it does require physicians to look at all of the ways that they use and access data today and determine whether that?s reasonable or not." to help you begin your HIPAA compliance process, following are some practical ideas for rethinking how you maintain and use patient information in your office. Appoint one or two staff members (depending on the size of your office) to review the HIPAA act, determine the changes your practice needs to make, and decide if you?ll need outside help. To keep this project manageable, do not wait until the last minute. Remember: most of the healthcare industry will have to be HIPAA compliant by April 14, 2003. Furthermore, compliance is not optional. Those found in violation of the act will be penalized: "Civil penalties range up to $25,000 per violation of each standard. Criminal penalties range up to $250,000 in fines and/or up to 10 years in prison."3

3.) Under HIPAA, covered entities (healthcare providers, health plans and healthcare clearinghouse) must comply with the privacy rules. A covered entity may develop its own privacy rules that would accommodate its own needs of protected health information (PHI) management but it most comply with the HIPAA guidelines. It is the responsibility of the entity to put in place a privacy official to oversee the policies, procedures and be on hand and available to be contacted in reference to the privacy rule. A patient should be given a privacy notice act at his/her health facility stating how their (PHI) is being used and to whom it will be shared. The covered entity should include in the notice their duty to assure the patients privacy as well as how and whom to contact if there is a complaint or they feel that their rights have been violated. As of 2009 the Office of Civil Rights (OCR) handles complaints that are made on privacy policies, procedure and practices of HIPAA covered entities.

I would say that I have seen when employees that work in a hospital that are walking across the hallways and elevator, I have heard them talking about a patient or they are speaking in another langue about a patient. The conversation was clearly about a patient not about work related because it was clearly and understanding on who they was talking about. They could have lost their job if they was caught. Every employee should know there precautions and not talk about patient information in hallways or any publics places, If it’s work related it should be spoken in the office behind a closed glass window and doors. A patient that would of witness an HIPPA violation and knew about how HIPPA violation works and felt threaten about the conversation

The rules in "Health Insurance Portability and Accountability Act of 1996" require that organizations will create policies and procedures to prevent unauthorized access to health care information. All persons who maintain and transmit health information apply reasonable technical and physical safeguards to ensure the integrity and confidentiality of such information and unauthorized uses or disclosures. However the existing problems of security of data are not yet fully overcome and the existing problems relating to patient record confidentiality and the impact

HIPAA mandated regulations that govern privacy, security and electronic transaction of patient health information. This means that patient information must be kept private and secure. Only provider or nurse who must have the permission of patient to provide care or to process records must know about patient health information.