HIPAA And ACA Act Essay Example

The HIPAA and Affordable Care Act was passed by the Congress in 1996.This Act has provisions that provide for the transfer and continuation of the health insurance coverage to millions of workers in America and their families even in instances when they either lose or change their jobs. The Act also puts measures to reduce fraud and abuse cases in the health care provision sector. The Act also puts into place requirements to maintain industry –wide standards for the handling of health care information relating to electronic billing and other electronic data (U S Department of Health and Human Services (n.d).
The Act puts provisions for the protection of confidentiality when handling health information that needs to be protected (American Medical Association, 2015).The HIPAA demands compliance by the health care providers. Included are the providers of therapeutic, palliative, preventive, and diagnostic among other health procedures that relate to both physical and health status of an individual. Also included are businesses that deal with the processing of health information that has been forwarded to them by other businesses that deal with health matters. These include physicians and hospital billing services. Individuals and groups that are involved in meeting the cost of medical care include Medicaid and Medicare programs (California Department of Health Care Services, 2014). Protected health information includes the patient’s present, past or future physical and mental health records. The mentioned health records have personal information, for instance, telephone and physical address, social security numbers and any other unique identification number.

Compliance deadlines for HIPAA and Affordable Care Act include

April 1, 2014 for the hearing on evaluation and reviewing of the adopted operating rules and standards
July 1, 2014 as the deadline for the provision of the recommendations for the updating and improvement of the set standards and operating rules
The ruling on any amendments to the standards and operating rules that have been approved by the review committee must be adopted within 90 days of the committee’s producing the report. The amendment on the review can be done after 25 months, usually after the closure of the 60-day window period provided for the public to comment.
Definition of covered entities demands that individuals, institutions, organizations and agencies must completely with HIPAA rules that intend to protect the security and privacy of information. Also, the named persons must furnish individuals with specific rights pertaining to their health information. The covered entities only cover the individuals, organizations and agencies who meet the definition of covered entities. The mentioned entities protect the individual privacy of information. Examples of covered entities include Health Plan, Health Care Provider and Health Care Clearinghouse
Noncompliance attracts an array of civil penalties that are in the form of fines depending on the provision that has been violated. For instance, offences that is committed with the intention to transfer, use or sell health information to gain commercial advantage or for malice attracts a fine of a maximum of $ 250,000 accompanied by a fine of a maximum of ten years (American Medical Association, 2015).The covered entities for violation include the clearinghouses, HealthCare providers and healthcare plans that do transmit medical claims electronically and any other agencies that may act on their behalf. The law only permits sharing of the minimum health information of a client that is necessary for the conduction of the billing business.

References

American Medical Association (2015) HIPAA Violations and Enforcement.Retriced on 26 March 2015http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/hipaa-violations-enforcement.page?
California Department of Health Care Services (2014) Health Insurance Portability and Accountability Act Retrieved on 26 March 2015 http://www.dhcs.ca.gov/formsandpubs/laws/hipaa/Pages/1.00WhatisHIPAA.aspx
U S Department of Health and Human Services (n.d) Improving the Health, Safety and WELL BEING OF America.Retrieved on 26 March 2015 .http://www.hhs.gov/ocr/privacy/hipaa/understanding/