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Health Insurance Portability and Accountability Act Quiza Marie C. Rodriguez American Intercontinental University (Ethical and Legal Issues in Healthcare) October 8th, 2019 1

Health Insurance Portability and Accountability Act

When it comes to the healthcare field never expect anything about healthcare to stay the same. The healthcare field is constantly evolving to provide better quality care for not only the patients, but healthcare professionals as well. The type of changes that occur in the healthcare field are things such as equipment, technology, rules/regulations, and new health care acts get introduced. These acts are in place so that patients can receive the best care and the healthcare professionals know what exactly is expected from them/what they need to do. Some of these acts you think would have been brought into the healthcare field a long time ago, because of the way the healthcare field is now. An act you would be surprised about that is pretty recent is the Health Insurance Portability and Accountability Act, also known as HIPAA. In the year of 1996 is when the Health Insurance Portability and Accountability Act (HIPAA) was established. However, the privacy rule “D-Day” was set for April 14 of 2003. “On December 4, 2002, the Office of Civil Rights (OCR) within the federal Department of Health and Human Services (DHSS) issued a written guidance on the HIPAA privacy rule. Specifically, the guidance was entitled the “OCR Guidance Explaining Significant Aspects of the Privacy Rule” ((OCR Guidance)” (Michael Plochocki, April 2003)). The Health Insurance Portability and Accountability Act is split into two sections. One section ensures that people are able to keep health insurance when they are between jobs, so that individuals can still receive the medical help they need when they are currently unemployed. This section is known as the Health Insurance Portability part of the act. The second section of the Health Insurance Portability and Accountability Act is known as the Accountability portation of the act. This section is responsible for ensuring the patients information/data remains confidential and secured 2

(Guidance, October 2006). It is amazing that it honestly took so long for this act to be what it is today. So, What led to the enactment of the Health Insurance Portability and Accountability Act? You ask. Well, in all actuality what we all know as HIPAA was originally introduced to congress as the Kennedy-Kassebaum Bill. The act was enacted as a broad Congressional attempt to reform our healthcare environment. When an act is passed it is important to understand what the act covers. With that being said, what does the Health Insurance Portability and Accountability Act cover? This act covers the patients health plan, health care clearinghouse, a patients’ health care provider and the health care. Firstly, a health plan coverage means that the plan to care for the patients’ medical problems will be paid for. Secondly, health care clearinghouse coverage means “a public or private entity, including a billing service, repricing company, community health management information system or community health information system, and “valueadded” networks and switches that either process or facilitate the processing of health information received from another entity in a nonstandard format or containing nonstandard data content into standard data elements or a standard transaction, or receive a standard transaction from another entity and process or facilitate the processing of health information into a nonstandard format or nonstandard data content for the receiving entity” (U.S. Department of Health and HUman Services National Institutes of Health, February 2007). Thirdly, a patients’ health care provider coverage means that the type of health care professional that is needed of service will be provided for and taken care of. Finally, health care coverage means any kind of care pertaining the patients’ health will be taken care of including being diagnosed, assessments, equipment, medications, and more. 3

It is important that healthcare professionals follow the rules and regulations of the Health Insurance Portability and Accountability Act. One reason being because it is the right thing to do for a patient and also because it must be obeyed by. Just like any other rule that is broken consequences will occur if the rules and regulations are violated. If violations of the Health Insurance Portability and Accountability Act are violated than criminal penalties will follow directly behind the violation. Depending on how severe the individual violationed the the Health Insurance Portability and Accountability Act, they can either suffer between the lowest level of penalties and the highest level of penalties. Which indicates that the individual can face up to $50,000-$250,000 in fines or they can serve from one year imprisonment to five years imprisonment for the violations the commited (HIPAA JOURNAL, 2014-2019). The Health Insurance Portability and Accountability Act is in place so that individuals can receive the health care they did in order to live their best quality of life as possible without having to worry about other people knowing their information. 4

References

● (Michael Plochocki, April 2003) Everything You Wanted to Know about HIPAA but Were Afraid to Attempt to Understand http://web.b.ebscohost.com.proxy.cecybrary.com/ehost/pdfviewer/pdfviewer?vid

=1&sid=4eb9d622-e7dc-4a9c-9eaa-0acc77ad1478%40pdc-v-sessmgr02 ● (Guidance, October 2006) HIPAA BACKGROUND http://hipaa.bsd.uchicago.edu/background.html

● (U.S. Department of Health and HUman Services National Institutes of Health, February 2007) To Whom Does the Privacy Rule Apply and Whom Will It Affect https://privacyruleandresearch.nih.gov/pr_06.asp

● (HIPAA JOURNAL, 2014-2019) What is the Civil Penalty for Knowingly Violating HIPAA https://www.hipaajournal.com/civil-penalty-for-knowingly-violating-hipaa/ 5

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