| The Health Insurance Portability and
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| | individual health information, and
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| Accountability Act or HIPAA, which was
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| | providers who electronically maintain
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| enacted by the US Congress in 1996, has
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| | health information used in electronic
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| introduced to sweeping changes in health
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| | transmissions between entities.
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| care administration and information
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| | Non-compliance with HIPAA regulations may
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| systems. HIPAA is a federal law that has
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| | cause disruptions in an organization's
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| been amended to the Internal Revenue Code
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| | day-to-day business processes, resulting
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| of 1986 which intends to improve
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| | in both tangible and intangible costs.
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| portability and continuity of health
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| | The most serious implications of HIPAA
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| insurance; combat waste, fraud and abuse
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| | non-compliance for health care
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| in health insurance and health care
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| | organizations include the inability to
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| delivery; promote the use of medical
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| | effectively conduct electronic business
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| savings accounts and improve access to
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| | and the potential of losing significant
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| long-term health care services and
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| | segments of business. The government also
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| coverage; and simplify the administration
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| | imposes some sanctions on those who fail
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| of health insurance.
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| | to comply with the regulations of HIPAA.
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| HIPAA is designed to standardize the way
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| | The penalty for failure to comply with
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| all health care organizations
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| | regulations goes up to $100 per violation
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| electronically exchange sensitive patient
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| | per person up to a maximum of $25,000 per
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| data and to protect patients from
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| | year. Penalty for knowingly and
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| unauthorized disclosure of their medical
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| | wrongfully disclosing individually
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| records (whether paper or electronic).
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| | identifiable health information is up to
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| Under HIPAA, there are specific standards
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| | $50,000 per violation or one year
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| that all health care organizations are
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| | imprisonment or both for simple offense;
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| required to adhere to. These standards
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| | up to $100,000 per violation or five
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| include an Administrative Simplification
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| | years imprisonment or both if the offense
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| Title that is aimed at preventing health
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| | is "under false pretenses"; and up to
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| care fraud and abuse. Within this title,
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| | $250,000 or ten years imprisonment or
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| there are several laws and proposed
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| | both if committed with intent to sell,
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| standards including Electronic Health
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| | transfer or use for commercial advantage,
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| Transactions Standards, Privacy &
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| | personal gain or malicious harm.
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| Confidentiality Standards, Unique Health
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| | Thus, the ultimate objective of HIPAA is
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| Identifiers, and Security & Electronic
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| | to increase the efficiency and
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| Signature Standards.
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| | effectiveness of health information
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| These HIPAA laws and standards directly
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| | systems through improvements in
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| apply to the following groups of health
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| | electronic health care transactions as
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| care entities: health plans, public and
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| | well as to maintain the security and
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| private payers, health care insurers,
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| | privacy of individually identifiable
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| HMOs, Medicare, Medicaid, group health
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| | health information. It helps to promote
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| plans, health care clearinghouses, any
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| | the modernization of health information
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| entity that facilitates the processing of
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| | systems. Becoming HIPAA-compliant is a
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| non-standard formatted health information
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| | challenging task because of extensive
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| and must convert the non-standard data
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| | cross-departmental compliance and
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| into standard transactions, or vice
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| | training requirements but it is an
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| versa, Health Care Providers, providers
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| | ongoing administration, privacy and
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| who transmit health information
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| | security challenge that must be
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| electronically, providers who receive
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| | constantly addressed.
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