The HIPAA stands for the Health Insurance Portability and Accountability Act of 1996. The purpose of the HIPAA was to improve the quality of the health care system by creating a standard for how information was exchanged between the various facilities.
This organization was created under the health care reform policy of the Clinton administration. The new laws associated with the creation of the HIPAA encouraged the formation of information systems that would standardize management and finances using the Electronic Data Interchange (EDI).
The HIPAA regulates many different aspects of the health care system including, health care providers, health plans, and health care billing services. All of the things that the HIPAA regulates are referred to as covered entities.
The term covered entities defines a health care provider as one who performs certain transactions in electronic form. The broad definition of the HIPAA is that they mostly deal with anyone involved in the transfer of electronic information.
A few examples of these covered entities would be health insurers, doctors, hospitals, employers who provide health insurance, life insurers, anyone who uses health care or health insurance, public health authorities, billing agencies, information system vendors, and health service organizations.
The HIPAA is made up of several sections including insurance portability, fraud enforcement or accountability, and administrative simplification. The term portability refers to the idea that one who changes health plans will not have a break in their coverage or be denied coverage due to previously discussed specifications.
Under the insurance portability section, the HIPAA also helps to regulate the accessibility and width of the coverage of group and individual health plans. For example, the HIPAA changed the Employee Retirement Income Security Act, the Public Health Service Act, and the Internal Revenue Codes.
Accountability refers to the government's enforcement of certain measures on those who are found to be practicing fraud. Those practicing fraud will be held accountable for their actions.
Administrative simplification, or the privacy rule, guarantees that all health related and personal information will be protected. This was a fairly new rule at the time which defined new regulations for who was able to access these health-related records.
While the HIPAA does not cover research, they can disclose some health-related information to researchers with the proper permission. Research institutions are not regulated by the HIPAA because they are not considered to be a covered entity.
The purpose of the Privacy rule states that the use and disclosure of health related information will be limited and restricted to the minimal amount necessary to meet the intended purpose. It also states that patients will be given the right to know that their information is being used for research purposes.
The penalties for violating the Privacy rule include a $25,000 fee for several infractions in one year. A $250,000 fee and/or 10 years of being imprison will be imposed on anyone who consciously violated this rule and misused someone's information.
The information protected by this privacy rule includes all information used by the researchers. This information is the demographic identity information, treatment or health conditions at anytime, and the medical payments that individual has paid and owes.
Demographic information includes names, addresses, employers' information, account numbers, social security information, photographs and contact information among a long list of many other things. These confidential items are referred to as Protected Health Info (PHI).
The new privacy rules have limited the ability for researchers to perform their work in some ways. They are no longer able to contact patients whose information they are studying for a follow-up interview.
One statistic from the University of Michigan said following the enforcement of the HIPAA rule follow-up interviews and survey dropped from 96% to 34%. This rule has also lead to researchers tripling the time it used to take to recruit patients which results the tripling of the costs of recruitment.
Many fear that the privacy rule will cripple the quality of research, while making research unaffordable. It has also led to doctors and other medical practitioners to err on the side of caution by refusing to release information to many who may have the right to the information, such as close family members.
The HIPAA has made many people feel that their information is safe, but this could be hindering progress that could otherwise be made without it.
Author Resource:-
Tom Selwick has worked since 1991 as a medical transcriptionist providing hospitals, clinics, and large group practices with medical transcription services.
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