There aren't many more industry where regulation is as stringent as in Healthcare. Healthcare is complicated. The issue comprises statutes, judicial decisions, myriad federal regulations, Guidance documents from the United States' Department of Health and Human Services, regulations of State Departments of Health, and standards of accreditation organizations such as the Joint Commission on the Accreditation of Health Care Organizations (JCAHO). But, perhaps, the largest bit of regulatory reform that hospital executives and General Counsel have to cope with, is the HIPAA which was passed in 1996. Since its passing, huge amounts of money have been spent by Hospitals on HIPAA consulting, HIPAA lawyers, and other such precautions to make sure they are in compliance with these complex standards. While it is true that HIPAA is a very large dog with rather sharp teeth (penalties can reach a maximum of over $1,500,000, and enforcement has been ramped up with the HITECH Act revision of the Privacy and Security Rules), and the Privacy and Security Regulations comprise more than eight hundred pages, there are only a few basic themes underlying the HIPAA privacy concept. Just as flicking a light switch illuminates a room, obtaining a level of comprehension regarding the basics of HIPAA regulations can cure an organization's constant worrying and provide some clear focus for how to go about ensuring compliance. The HIPAA regulations are divided into two Rules: HIPAA Privacy and Security. HIPAA Security's goal is to ensure that HIPAA privacy is in compliance by mandating standards that protect electronic health information of all types. The Privacy Rule is designed to prevent unauthorized use or disclosure of Protected Health Information (PHI). PHI, which may be paper-based or digital, is defined in the Privacy Rule as information regarding treatment or requests for treatment which may be identified with an individual person by one or more of 18 identifiers (name, social security number, etc.). The Privacy Rule is known as a regulation of exclusion it ensures a patience right to privacy by not allowing PHI from being disseminated for things other than for the purposes of treatment, payment or operations of a healthcare provider or plan, unless it is explicitly authorized by a patient. Exceptions include emergencies, as defined, uses or disclosures required by law, and provision of PHI to third-party contractors whose work requires access to PHI. Such contractors are known in the industry as Business Associates. Privacy Rules mandate that a Business Associate Agreement be signed wherein parties agree to follow the regulations set forth by HIPAA. After February 1, 2010, however, Business Associates are directly covered by HIPAA, meaning they must comply with its requirements as though they were healthcare providers or plans. Healthcare consulting entities and HIPAA lawyers (healthcare attorneys with a specialty in HIPAA law) can, by being outside entities, facilitate the necessary discussions to focus this healthcare compliance initiative by preparing Gap Analysis Reports, in which they review policies and procedures on handling of healthcare information and make recommendations to bring those protocols into compliance. The precepts are not complicated, at base: use or disclose patient information only for the permitted purposes, and secure patient authorization to sue it for anything not permitted by the Regulations. Most hospitals already have a culture of privacy; HIPAA lawyers and healthcare consulting entities, working with interdisciplinary teams at the hospital, can cost-effectively revise practices and policies to put these themes into practice, without changing the culture of the organization or unduly frightening the executive staff.
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HIPAA Law is complex. Find a HIPAA Consultant if you're interested in bringing your organization into compliance.
Linda Smith has written extensively on hipaa consulting and recommends hipaa lawyers to those trying to bring their companies into compliance.
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