HIPAA, patient privacy, data breach, and fraud require health care authorities, nursing homes, practitioners, and their business colleagues face precise needs under federal and state laws to safeguard public health information from healthcare breaches. One needs practical guidance on how to control the acceptance, threat management, and legal issues involved in the sophisticated area of protected health information (PHI).
Health Insurance Portability and Accountability Act (HIPAA) was legalized in the year 1996, by the then American President Bill Clinton. It is a law that provides safety provisions and data confidentiality to keep patients’ medical records intact from data breach fraud.
HIPAA contains five parts, in total:
HIPAA Title I objects to safeguard health coverage for those people who have replaced or lost their jobs. It halts group health schemes from declining to cover patients who had illnesses or medical conditions and disallows them from setting limitations for life insurance.
HIPAA Title II objects to allow the United States Department Of Human Services and Health to systematize the functioning of online healthcare transactions. It directs the authorities to apply a secure electronic approach to patient privacy, remaining in adherence to the security rules which were regulated by The United States Department of Health & Human Services (HHS).
HIPAA Title III is associated with tax-related facilities and proper medical care instructions.
HIPAA Title IV provides a further upgrade in health coverage, including amenities for those who have pre-existent illnesses or conditions and those searching for continuous insurance.
HIPAA Title V includes facilities linked with authority-owned coverage and treatment of those who lost their citizenship for not paying income tax.
HIPAA adherence
To upgrade the flexibility and flow of health insurance plans.
To fight cheating and abuse in health coverages. It includes executing the Privacy Rule, Security Rule, and Breach Notification Rule.
To enhance the use of medical savings accounts by regulating the amount that may be saved per individual in a pre-tax savings account.
To upgrade approach to permanent care services and insurance. It includes insurance of patients with pre-existing diseases.
To simplify tax reductions for authorities and other tax revenue articles.
What data is safeguarded by the HIPAA Privacy Rule?
The Individually Identifiable Health Information safeguarded by the HIPAA Privacy Rule is immense. Besides, as insurance companies often approach PHI for bills, personally distinguishable health data includes not only birth details, but also credit card data, vehicle enrolment plate numbers, and even patient’s digital handwriting. The HIPAA Privacy Rule not only relates to data in the penned format. The HIPAA Privacy Rule also safeguards videos and pictures containing any personally recognizable health data to prevent medical identity theft,.
PHI and the Minimum Necessary Rule
The HIPAA Privacy Rule also dictates when and how it should be revealed. Except for revelation for treatment, paycheck, or surgeries, any PHI regarding a patient’s history, present or future, physical or psychological health, the facilities of healthcare, or bill payment can only be revealed without consent from the patient to the patient’s advocate or family members:
When the revelation is needed by law.
When it is in the clients’ interest or the general interest.
To another HIPAA covered organization when harmony exists between that covered authority and the patient.
HIPAA Privacy Rules Summary
The HIPAA Privacy Rule was first approved in 2002 to safeguard the privacy of patient healthcare data breaches.
The HIPAA Privacy Rule not only pertains to healthcare authorities, but also healthcare schemes, healthcare nursing homes, and business authorities with access to Protected Health Information.
Protected Health Information comprises eighteen ‘Individually Identifiable Health Information’ which personally or together could divulge the identity of a patient, their medical archives, or payment record.
Risks to the uprightness of PHI
There are many risks to the uprightness of PHI. Measures need to be taken to mitigate both internal and external threats. Internal risks are often preferable to the use of personal mobile phones in the workstation. BYOD schemes have built measures in which up to 80 percent of healthcare authorities use smartphones or laptops to support their work. According to a Health Information Trust Alliance survey, 41 percent of PHI violations and patient data breaches are referable to the burglary of an employee’s mobile phone.
External risks are more menacing. Cybercriminals try to remove PHI by using phishing phone calls to fool unaware workers to download malware. The most troublesome types of downloads are ransomware, which disables computer systems through evil passwords, and supervision malware – which tapes keystrokes to send usernames and passwords back to the hacker for producing the malware. Cyberattacks are now accountable for more than half of the PHI violations delineated to the Department of Health and Human Services Office for Civil Rights.
Related Frauds
Dishonest actions in regards to billing involve:
Billing for products or facilities not provided or medically avoidable
Billing for facilities at a greater level then what was provided
Billing for more hours than is spent on the schedule
Billing for amenities that were performed by an improperly managed, unqualified, or unlicensed worker
Billing for facilities that were completed by a worker who has been debarred from participation in federal healthcare schemes
Billing independently for services already incorporated in a global amount
Billing for facilities insured by a third-party
Billing exceedingly for services or supplies
Failing to recognize and repay credit balances
Producing incorrect cost reports
Steps to avoid HIPAA Violations
Following are some steps to avoid HIPAA violations:
Recognize and obey company HIPAA and Privacy policies and processes.
Do not divulge anyone’s protected health information (PHI) with fellow workers unless it is for therapy, billing, or healthcare surgeries.
Do not share anyone’s PHI with family or friends.
Do not leave PHI ignored or authorized to be detectable to guests.
Validate you are following company scheme before dispatching PHI in an email or fax to anyone inside or outside the authority.
