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In certain circumstances, covered entities may disclose protected health information to appropriate government authorities regarding victims of abuse, neglect, or domestic violence.31, Health Oversight Activities. 164.512(g).36 45 C.F.R. Frequently Asked Questions for Professionals- Please see the HIPAA FAQs for additional guidance on health information privacy topics. For Notification and Other Purposes. 2 The Rule specifies a series of administrative, technical, and physical security procedures for covered entities to use to assure the confidentiality, integrity, and availability of e-PHI. Receive the latest updates from the Secretary, Blogs, and News Releases. including license plate numbers; (xii) Device identifiers and serial numbers; (xiii) Web Universal 164.504(f).84 45 C.F.R. 164.520(a) and (b). Through mobile devices, laptops, flash drives, CDs Workforce members include employees, volunteers, trainees, and may also include other persons whose conduct is under the direct control of the entity (whether or not they are paid by the entity).66 A covered entity must train all workforce members on its privacy policies and procedures, as necessary and appropriate for them to carry out their functions.67 A covered entity must have and apply appropriate sanctions against workforce members who violate its privacy policies and procedures or the Privacy Rule.68, Mitigation. HIPAA is a mandatory law for organizations operating in the United States that store, transmit, or use PHI data. These policies and procedures must identify the persons, or classes of persons, in the workforce who need access to protected health information to carry out their duties, the categories of protected health information to which access is needed, and any conditions under which they need the information to do their jobs. There are two ways to de-identify information; either: (1) a formal determination by a qualified statistician; or (2) the removal of specified identifiers of the individual and of the individual's relatives, household members, and employers is required, and is adequate only if the covered entity has no actual knowledge that the remaining 164.514(b).16 45 C.F.R. Demographics There are exceptionsa group health plan with less than 50 participants that is administered solely by the employer that established and maintains the plan is not a covered entity. A covered entity must designate a privacy official responsible for developing and implementing its privacy policies and procedures, and a contact person or contact office responsible for receiving complaints and providing individuals with information on the covered entity's privacy practices.65, Workforce Training and Management. Use passwords on desktop and portable media devices, and change them as often as your organization's policy allows. Here are some important facts to keep in mind: As a healthcare worker, if you are involved in the gathering, storing, and transmission of patient information, you MUST comply with HIPAA. The Privacy Rule excludes from protected health information employment records that a covered entity maintains in its capacity as an employer and education and certain other records subject to, or defined in, the Family Educational Rights and Privacy Act, 20 U.S.C. In addition, protected health information may be disclosed for notification purposes to public or private entities authorized by law or charter to assist in disaster relief efforts. Two types of government-funded programs are not health plans: (1) those whose principal purpose is not providing or paying the cost of health care, such as the food stamps program; and (2) those programs whose principal activity is directly providing health care, such as a community health center,5 or the making of grants to fund the direct provision of health care. A HIPAA violation is the use or disclosure of Protected Health Information (PHI) in a way that compromises an individual's right to privacy or security and poses a significant risk of financial, reputational, or other harm. Developed by the U.S. Department of Labor Pension and Welfare Benefits Administration Revised September 1998. 164.520(b)(1)(vi).73 45 C.F.R. All group health plans maintained by the same plan sponsor and all health insurers and HMOs that insure the plans' benefits, with respect to protected health information created or received by the insurers or HMOs that relates to individuals who are or have been participants or beneficiaries in the group health plans. HIPAA protects the privacy of Personal Health Information (PHI). 164.504(g).83 45 C.F.R. Covered entities may also disclose to law enforcement if the information is needed to identify or apprehend an escapee or violent criminal.40, Essential Government Functions. Covered entities that had an existing written contract or agreement with business associates prior to October 15, 2002, which was not renewed or modified prior to April 14, 2003, were permitted to continue to operate under that contract until they renewed the contract or April 14, 2004, whichever was first.11 See additional guidance on Business Associates and sample business associate contract language. 164.501.48 45 C.F.R. 164.512(k).42 45 C.F.R. The HIPAA breach notification requirements are important to know if an organization creates, receives, maintains, or transmits Protected Health Information (PHI). Self-insured plans, both funded and unfunded, should use the total amount paid for health care claims by the employer, plan sponsor or benefit fund, as applicable to their circumstances, on behalf of the plan during the plan's last full fiscal year. 164.501.22 45 C.F.R. It is a common practice in many health care facilities, such as hospitals, to maintain a directory of patient contact information. Immunizations It is important, andtherefore required by the Security Rule, for a covered entity to comply with the Technical Safeguard standards and certain implementation specifications; a covered entity may use any security measures that allow it to reasonably and appropriately do so. A covered entity may not retaliate against a person for exercising rights provided by the Privacy Rule, for assisting in an investigation by HHS or another appropriate authority, or for opposing an act or practice that the person believes in good faith violates the Privacy Rule.73 A covered entity may not require an individual to waive any right under the Privacy Rule as a condition for obtaining treatment, payment, and enrollment or benefits eligibility.74, Documentation and Record Retention. Collectively these are known as the. Progress notes Covered entities may use and disclose protected health information without individual authorization as required by law (including by statute, regulation, or court orders).29. An organization can require that these requests are in writing and that the individual explains the reason for the change. 1320d-5.89 Pub. Disclosures to or requests by a healthcare provider for treatment purposes (such as communication hand-offs). 160.102, 160.103; see Social Security Act 1172(a)(3), 42 U.S.C. Such information may also be disclosed in response to a subpoena or other lawful process if certain assurances regarding notice to the individual or a protective order are provided.33, Law Enforcement Purposes. For non-routine, non-recurring disclosures, or requests for disclosures that it makes, covered entities must develop criteria designed to limit disclosures to the information reasonably necessary to accomplish the purpose of the disclosure and review each of these requests individually in accordance with the established criteria. All healthcare workers must follow their organization's health information privacy and security policies and procedures mandated under HIPAA. The Privacy Rule permits use and disclosure of protected health information, without an individual's authorization or permission, for 12 national priority purposes.28 These disclosures are permitted, although not required, by the Rule in recognition of the important uses made of health information outside of the health care context. When a covered entity uses a contractor or other non-workforce member to perform "business associate" services or activities, the Rule requires that the covered entity include certain protections for the information in a business associate agreement (in certain circumstances governmental entities may use alternative means to achieve the same protections). By law, the HIPAA Privacy Rule applies only to covered entities - health plans, health care clearinghouses, and certain health care providers. A group health plan and the health insurer or HMO that insures the plan's benefits, with respect to protected health information created or received by the insurer or HMO that relates to individuals who are or have been participants or beneficiaries of the group health plan. In such instances, only certain provisions of the Privacy Rule are applicable to the health care clearinghouse's uses and disclosures of protected health information.8 Health care clearinghouses include billing services, repricing companies, community health management information systems, and value-added networks and switches if these entities perform clearinghouse functions. A covered entity must obtain the individual's written authorization for any use or disclosure of protected health information that is not for treatment, payment or health care operations or otherwise permitted or required by the Privacy Rule.44 A covered entity may not condition treatment, payment, enrollment, or benefits eligibility on an individual granting an authorization, except in limited circumstances.45. 164.502(b) and 164.514 (d).51 45 C.F.R. The Minimum Necessary Standard Rule does NOT apply to the following: 1. Oddly enough, the result is the correct Fahrenheit temperature. 164.502(a)(1).19 45 C.F.R. 164.528.61 45 C.F.R. (5) Public Interest and Benefit Activities. The EHR may include clinical data such as: Increased penalties for HIPAA breaches Past medical history 45 C.F.R. A covered entity may use or disclose, without an individual's authorization, the psychotherapy notes, for its own training, and to defend itself in legal proceedings brought by the individual, for HHS to investigate or determine the covered entity's compliance with the Privacy Rules, to avert a serious and imminent threat to public health or safety, to a health oversight agency for lawful oversight of the originator of the psychotherapy notes, for the lawful activities of a coroner or medical examiner or as required by law. In addition, certain violations of the Privacy Rule may be subject to criminal prosecution. 164.501.23 45 C.F.R. 164.502(d)(2), 164.514(a) and (b).15 The following identifiers of the individual or of relatives, employers, or household members of the individual must be removed to achieve the "safe harbor" method of de-identification: (A) Names; (B) All geographic subdivisions smaller than a State, including street address, city, county, precinct, zip code, and their equivalent geocodes, except for the initial three digits of a zip code if, according to the current publicly available data from the Bureau of Census (1) the geographic units formed by combining all zip codes with the same three initial digits contains more than 20,000 people; and (2) the initial three digits of a zip code for all such geographic units containing 20,000 or fewer people is changed to 000; (C) All elements of dates (except year) for dates directly related to the individual, including birth date, admission date, discharge date, date of death; and all ages over 89 and all elements of dates (including year) indicative of such age, except that such ages and elements may be aggregated into a single category of age 90 or older; (D) Telephone numbers; (E) Fax numbers; (F) Electronic mail addresses: (G) Social security numbers; (H) Medical record numbers; (I) Health plan beneficiary numbers; (J) Account numbers; (K) Certificate/license numbers; (L) Vehicle identifiers and serial numbers, including license plate numbers; (M) Device identifiers and serial numbers; (N) Web Universal Resource Locators (URLs); (O) Internet Protocol (IP) address numbers; (P) Biometric identifiers, including finger and voice prints; (Q) Full face photographic images and any comparable images; and any other unique identifying number, characteristic, or code, except as permitted for re-identification purposes provided certain conditions are met. 164.501.38 45 C.F.R. In March 2002, the Department proposed and released for public comment modifications to the Privacy Rule. the past, present, or future payment for the provision of health care to the individual. An organized system of health care in which the participating covered entities hold themselves out to the public as part of a joint arrangement and jointly engage in utilization review, quality assessment and improvement activities, or risk-sharing payment activities. Thereafter, the health plan must give its notice to each new enrollee at enrollment, and send a reminder to every enrollee at least once every three years that the notice is available upon request. A covered entity must make reasonable efforts to use, disclose, and request only the minimum amount of protected health information needed to accomplish the intended purpose of the use, disclosure, or request.50 A covered entity must develop and implement policies and procedures to reasonably limit uses and disclosures to the minimum necessary. 160.203.86 45 C.F.R. If identifiers are removed, the health information is referred to as de-identified PHI. Web Design System. 164.530(h).75 45 C.F.R. Restriction Request. It is a requirement under HIPAA that: a. Communications to describe health-related products or services, or payment for them, provided by or included in a benefit plan of the covered entity making the communication; Communications about participating providers in a provider or health plan network, replacement of or enhancements to a health plan, and health-related products or services available only to a health plan's enrollees that add value to, but are not part of, the benefits plan; Communications for treatment of the individual; and.