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Who is affected by HIPAA?
HIPAA is the most far reaching legislative act passed since ERISA. It directly
affects healthcare providers all across the nation. It will be a culture change
and alter the way the healthcare sector does business. It also affects the health
insurance business, and the people healthcare practioners do business
with.
However, not all healthcare providers must comply with the privacy and security regulations.
The regulations makes a distinction between those that use electronic
transmission of data and those that don't. There are no distinctions between sizes of healthcare providers when it comes to HIPAA compliance. The only exception is that mental health providers must follow special, more stringent rules.
Electronic transmission of data means if your firm transmits any patient
information to anyone else you fall under the HIPAA rules. It also says if you
give the information to someone like a billing service or third party claims
service and they transmit it electronically, it is the same as if you did it.
Health and Human Services has been asked to clarify whether faxes are electronic
transmission. At this writing they are not, although many consider it to fall
under the regulations as electronic. On October 16, 2003, Medicaid and
Medicare require all claims to be submitted electronically. (There
are some exceptions for a small provider of services or suppliers. Click here
for a clarification from HHS on who is a small provider.) With
the savings that come from electronic versus paper claims, many firms that do
not submit electronically may very well find themselves doing it or having
someone else do it for them.
HIPAA will require changes to how
an office operates. While it's very likely that you already have some privacy and security measures in place, HIPAA requires that you document those policies and procedures.
And it requires that your employees be trained in the HIPAA law and the policies
& procedures of your office.
Another group of businesses that have a direct impact from HIPAA are Business
Associates of the covered entity. A Business
Associate is an individual or entity that receives protected health information (PHI) from a covered entity, such as a medical practice, so that the business associate may perform services or functions, or assist in the performance of services or functions, on behalf of the covered entity.
HIPAA mandates the covered entity require a Business
Associate (BA) to sign
a Business Associate Agreement
(BAA). This agreement pulls parties that normally
do not fall under the definition of a covered entity right into the HIPAA water.
The agreement requires the BA to offer the same protection of the data as the
covered entity must and it is a contract enforceable in court. If the BA does
not sign the agreement or fails to protect the data, HIPAA requires the covered
entity to terminate relationship with the BA. Bottom line is BA's must follow
the same guidelines as a covered entity. A BAA
can also be an addendum to an existing business agreement and does not have to
be separate.
What are examples of Business Associates?
- Lawyers
- Accountants
- Consultants
- Billing Companies
- Collection Agents
- Practice Managers
- Medical Transcription Service
An employee of the covered entity or a member of the covered entity's own workforce is not considered a business associate.
Independent contractors are Business Associates. Also, other health care providers to whom covered entities disclose PHI for treatment purposes are
considered business associates, too. This includes other covered entities
as well as those not directly affected by HIPAA.
Business Associates
need to demonstrate "HIPAA Compliance" by going
through the same processes that a covered entity must. This means setting up a manual
for HIPAA policies & procedures and training employees. BA.HIPAAps.com
Business Associate
version is designed to simplify that process and is offered along side this
web site.
A side note: even though HIPAA applies directly to a defined group of
"covered entities" and not to others, it is an universal set of
privacy guidelines. It is very likely over the long term ALL firms involved with
protected health information may see the guidelines apply in other ways.
Consider this, if you were to seek care from a medical provider and one says
they are HIPAA complaint and follow the guidelines, the other says HIPAA what
and has no intention of complying voluntarily, which one would you go to? Same
applies to a firm like a lawyer. Suppose you needed an attorney to represent you
in a conversation that included your personal medical history, which law firm
would you use, one that is HIPAAps certified or one that is not? As the public
becomes more HIPAA aware, they will expect if not demand privacy compliance.
Going through HIPAA privacy rules compliance can seem difficult, however there are ways to make it much easier.
HIPAAps.com was designed to make the process as simple as possible. We have
reduced the process to a matter of steps to produce a HIPAA policies and
procedures manual for your
office. We also offer an excellent web based tool for training your employees on
HIPAA and your policies and procedures.
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