Monday, February 24, 2014

What is HIPAA? Why Does my Practice Need to Comply?

Published by Pradip Sengupta, CEO of IPS Technology Services

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 was enacted by Congress with two titles (or sections). The first title protects an individual’s access to healthcare and portability of coverage when there is a pre-existing condition. The second title—which is of utmost importance to the healthcare industry—protects identifiable patient healthcare information by implementing safeguards to prevent healthcare fraud, providing for medical liability reform and providing administrative simplification to allow for compliance to these requirements.
Under HIPAA, health care providers MUST provide adequate security protection for all patient electronic medical records (EMRs). Disseminating personal, identifiable healthcare information or failing to prevent the theft or use of such information can result in very hefty fines, paid to the U.S. Department of Health & Human Services. Failure to comply with HIPAA regulations can cost a provider up to $1.5 million per calendar year in fines. In 2012, the most prevalent violation of HIPAA was the failure to protect private medical records from theft—an offense that the United States government treats as seriously as the willful dissemination of patient medical records.

Violations of HIPPA can affect large entities such as hospitals, health insurance companies and pharmacies as well as smaller entities like medical and dental practices. The U.S. Department of Health and Human Services identifies these violations through randomized audits and audits triggered by non-compliance events. As more patient records are being transferred to electronic media, electronic security and privacy is becoming very important to protect patients and reduce fraud. If not done correctly, healthcare providers put themselves and their practices at risk of fines, lawsuits, and in some cases, jail time for the involved parties.

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