HIPAA FAQ's What is HIPAA? The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was a result of congressional healthcare reform proponents to reform healthcare. The HIPAA legislation has four primary objectives. * Assure health insurance portability by eliminating job-lock due to pre-existing medical conditions * Reduce healthcare fraud and abuse * Enforce standards for health information * Guarantee security and privacy of health information Of the four primary objectives, the fourth objective has the most impact on medical transcription. What is the deadline for HIPAA compliance? The rule requires that healthcare organizations insurers and payors that have been using any electronic means of storing patient data and performing claims submission must comply with the this rule by April 14, 2003. Since medical transcription deals with electronic means of handling and storing patient data, April 14, 2003 is the deadline by which medical transcription service organization (MTSO) must comply with the HIPPA requirement. What are the important requirements of HIPAA for a medical transcription company? MTSOs must be able to support two requirements. 1. Ensure the security and confidentiality of the patients Protected Health Information (PHI), and 2. Maintain an audit trail of all individuals who have had access to a PHI. This means that transcription service providers must implement technology and business processes in their operation to support these two key requirements. Can the Internet be used for medical transcription and still meet HIPAA requirements? Yes, as long as the MTSO uses encryption and password protection to prevent unauthorized access to the PHI. Dictations done on a telephone does not need to be encrypted. However, voice files transmitted by portable recorders should be encrypted prior to transmission over the Internet. Transcribed documents must be sent back to the healthcare provider in a secure manner using encrypted email or a secure FTP site or may be faxed with a disclaimer statement explaining the confidential nature of the document. If tapes are used to record dictations, will this meet HIPAA regulations? This may cause a problem. There is no easy way to create and verify an audit trail of who has had the tape and who listened to the PHI on the tape. If the tape is lost, one cannot guarantee the security of the information on it. Who and what is a Covered Entity and a Business Associate? HIPAA defines a Covered Entity (CE) as a health plan, a healthcare clearinghouse, or a healthcare provider who transmits any health information in electronic form in connection with a HIPAA transaction. A physicians office or medical clinic would fall under the category of a Covered Entity. A Business Associate (BA) is a person or organization that performs a function or activity on behalf of the Covered Entity (CE), but is not a part of the covered entitys work force. A medical transcription service provider would be classified under the definition of a Business Associate. Who is liable for privacy violation under HIPAA? Civil and criminal penalties can be imposed for noncompliance with HIPAA. The imposition of these penalties are against Covered Entities (e.g. healthcare provider) but not directed directly against Business Associates (e.g. medical transcription service organization). Healthcare providers should ask their transcription company about their privacy and security regulations and ensure that they are contractually obligated to comply with these regulations. What is the penalty for not meeting HIPAA compliance? The total amount from civil penalties for multiple violations by a Covered Entity during a calendar year is capped at 25,000. HIPAA also provides from criminal liability for Covered Entities for knowingly obtaining or disclosing individually identifiable health information. The maximum penalty is a fine of 50,000 and imprisonment of one year. If the offense is committed under false pretenses, the maximum penalty is a fine of 100,000 and imprisonment of five years. If the offense is committed with the intent to sell, transfer or use individually identifiable health information for commercial advantage, personal gain or malicious harm, the maximum penalty is a fine of 250,000 and imprisonment of ten years. What rights does the patient have under HIPAA? HIPAA provides the patient with many new rights in relation to their healthcare documentation. Some of them are: * Review his/her entire medical record * Request changes within documentation, which can be denied by physician for specific reasons * Request documentation of every time his or her PHI was accessed, along with identity of the individual accessing the document with specific reason for doing so * To know how much of the PHI information was shared * What the facility (Covered Entitys) policies and procedures are for security and privacy When the patient becomes aware of these rights you should be prepared to deal with any legitimate requests the patient may have.
Cyberservices 2003