Health Insurance Regulation In Health Care

Health information is a fundamental piece of data which represents a person, business, organization, or a community. This data is vital in monitoring and coordination of care for individuals and communities. It not only monitors and coordinates patient care, but reduces costly mistakes and prevent duplication of treatments as well as taking a pivotal role in preserving, securing, and protecting personal health information. Since, this information is extremely essential and sensitive, it must remain secure and safe to prevent frauds and cyber-attacks. First of all, this paper discusses vitality of the health information in regards to individuals, professionals, and organizations along with its benefits to improve overall quality of life. Secondly, it discusses the role of information technology in various aspects of the industry and the what the future holds within IT.

There is no doubt in that technology has multifaceted benefits but, at the same time, it has forced mankind to feel insecure. Every industry depends upon the data of the customers and the health industry is no more an exception here. The data of each patient is shared to facilitate health itself and for more rigorous and authentic research. Hence, protecting patient data is very important. It is so important that in 1996, the federal government introduced the Health Insurance

The purpose of this paper is to discuss the electronic health record mandate. Who started it and when? I will discuss the goals of the mandate. I will discussion will how the Affordable Care Act ties into the mandate of Electronic Health Record. It will describe my own facility’s EHR and what steps are been taken to implement it. I will describe the term “meaningful use,” and it will discuss possible threats to patient confidentiality and the what’s being done by my facility to prevent Health Information and Portability Accountability Act or HIPAA violations.

The Health Insurance Portability and Accountability Act (HIPAA) was passed by congress in 1996, and helps to ensure the privacy and security of Electronic Health Records (EHR's). By following the rules and regulations set forth under HIPAA, we can ensure the safety of patients' EHR's. We are responsible for protecting patients' records, and there are many measures we can take in order do this. Firstly, we must always keep patients' health information private. This means no discussing the records with people that are not authorized to know, and even then, we should only disclose the minimum necessary amount of information possible. For covered entities, we must designate a privacy and security officer to ensure the privacy

Modern communications capabilities open up a world of possibilities for all types of medical practices to develop deeper connections with their patients and to manage health care remotely. The HIPAA Privacy Rule gives patients the right to obtain copies of their medical records, treatments and protected health information or PHI. These requirements go further if medical providers want to receive reimbursement from Medicare and Medicaid -- patients must be able to access their records online, download copies and transmit the information to third-party providers. Most medical practices are finding it necessary to develop patient portals where patients and physicians can interact, share information and perform important functions such as practices billing patients and accepting payments online. HIPAA 's rules require that these patient portals have strong security and privacy protections to prevent unauthorized access of these confidential PHI records.

The Health Insurance Portability and Accountability Act (HIPAA) was intricately designed to provide not only a more efficient health care system but also as a protection for private patient information and data. With the widespread use of technology and computers in hospitals, the availability of patient information, their health portfolio, and their previous care has greatly improved the efficiency of health care. However, this also means that there is greater leeway for that information to be lost and/or shared without patients consent.

Medical treatments require a great deal of paperwork. Before patients are allowed to go through treatments, a clinic must process their insurances, medical records, and surgery details. As a result, a lot of private information is gathered within the hospitals. With so much private information, it is essential for healthcare facilities to efficiently organize their paperwork. An unorganized recording system can prove disastrous to a hospital. Leaving patients’ paperwork publicly unattended and misplacing a file are both considered negligent. Misplacing patients’ information can potentially lead to information theft and invasion of privacy. An efficient way of storing information can be valuable in preventing HIPAA

The federal requires the healthcare organizations to adopt and demonstrate the use of electronic medical records (EMR) or the electronic health records (EHR). They contain patient’s medical history and it

The significance of patient privacy and the security of confidential information are increasingly vital given the approval of electronic health records. Healthcare providers have recognized striking prices due to security threats and subsequent breaches. According to U.S. Department of Health and Human Services (2002), under the Privacy Rule healthcare establishments must establish protections that establish procedures and rules that guarantee least levels of privacy in relation to patient information. When violations are recognized, it is required that a compliant be created by the individual or unit experiencing the violation. In the complaint, the name of the person who participated in the violation, in addition to the nature of the violation, must be comprehensive. The filing of the complaint initiates an investigation by the Secretary of the U.S. Department of Health and Human Services under HIPAA values (U.S. Department of Health and Human Services, 2013). The establishment of a procedure related to privacy violations has resulted in many cases relating to electronic data breaches. Next is a consideration of two such cases to demonstrate the role of privacy in regards to HIPAA and electronic health database breaches.

According to U.S. Department of Health and Human Services (n.d.), the migration of healthcare providers to using electronic health records and the wide-spread use of computer and web based applications motivated the U.S. Department of Health and Human Services to develop regulations for protecting the privacy and security of Private health Information (PHI) of individuals. The advance in computing technology and easy storage options, led healthcare providers change their physician order entry, patient health records, pharmacy, laboratory systems, health insurance plans to fully computerized systems. While the change facilitates work efficiency and increased quality of service by ensuring greater mobility and easy access to information anywhere at any time, it adds potential security and privacy risks (Mercuri, 2004). HIPAA requires that every covered entity keep the privacy of individuals and implement acceptable form of security to protect the integrity, availability and confidentiality of private health information. According to U.S. Department of Health and Human Services (n.d.), the goal of the Security Rule is to safeguard the security of electronic private health information (ePHI) while giving more flexibility to covered entities such as healthcare providers, healthcare clearing houses and insurance companies in using new security technologies to better the quality of service and healthcare. The HIPAA Security Rule is updated on a regular basis

Privacy of health information has become an area of emphasis across the healthcare industry. It is important to understand what data is protected under federal regulations, how it can be shared, and how to prevent any accidental exposure of protected data. It is possible that data that should be protected can be exposed without anyone even realizing a violation has occurred. Exposure of protected healthcare data can result in medical identity theft and is therefore a very important and hot topic. The security and privacy of healthcare data is necessary to ensure consumer confidence in the healthcare industry and to prevent medical identity theft.

Much debate over the social regulation policy of healthcare insurance through the Affordable Care Act has been on its efficacy by requiring Americans to be insured. The most recent public poll for November from the Kaiser Family Foundation has indicated 35% of respondents favored the policy with 45% finding it unfavorable (Kaiser). Individuals favoring this policy are in support of extending health insurance coverage to those who would otherwise be unable to afford it due to costs or pre-existing conditions. Those against this policy are concerned of the costs behind expanding public insurance to millions more individuals will be more than private insurance due to a wider range of benefits under public care (Ku and Broads, w318).

The department of Health and Human Services protects and guides the health and well being of individuals here in America (Thacker, 2014). They fulfill these duties providing Americans with adequate and efficient health and human services and monitoring services designed to increase the efficiency of care in the health system (Thacker, 2014). One of the services being monitored by the department of Health and Human Services is the electronic health record system, which carries private and vital information of patient’s health record enabling all eligible participating health workers access to these records (Thacker, 2014). A breach of the protective health information of patients in a health organization creates chaos as these are against the health insurance portability and accountability (HIPAA) law (Thacker, 2014). Hence, measure will have to be put in place to determine what caused the breach and how to rectify it to ensure the breach never happens again (Thacker, 2014).

In light of available security measures and their widespread acceptance within the information security community, there is no excuse for healthcare organizations to fail in fulfilling their duty to protect personal patient information. Guaranteeing the confidentiality and privacy of data in healthcare information is crucial in safeguarding the data of patients as there should be a legal responsibility to protect medical records from unauthorized access.

The correlation of increased potential patient rights violations and sensitive personal health data among electronic medical records than paper records is growing at an alarming rate. An estimated 52,000 public comments was reviewed by the Department of Health and Human Services requiring privacy regulations governing individually identifiable health information since the passage of Health Insurance Portability and Accountability Act of 1966 (HIPPA). The individually identifiable health information includes demographic data that relates to the individuals past, present, or future physical or mental health condition. In addition, the provision of health care rights of the individual, confidentiality, protection of