HIPAA Health Insurance Portability and Accountability Act of 1996

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HIPAA Health Insurance Portability and
Accountability Act of 1996

• Belmont University

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HIPAA

• Originally designed to improve the portability of
  health insurance coverage (1996).
• Recent legislation (2002/2003) standardizes
  health care transactions to impose privacy and
  security requirements.

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What is protected?

• Protected Health Information (PHI)
• Medical
• Dental
• Vision
• Prescription drug benefits
• Healthcare Flexible Spending Account
• Employee Assistance Program (EAP)

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What is NOT covered?

• Workers Compensation
• Family Medical Leave Act
• Supervisor/employee discussions of absences and
  requests for doctors excuse

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Why is Belmont covered?

• Belmont is covered because of our Employee
  Welfare Benefit Plan and the Student Health
  Clinic, with respect to individually identifiable
  health information or PHI
• As a small health plan, Belmont University must
  be compliant with HIPAA beginning April 14, 2004.

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By law . . .

• Belmont is required to
• Make sure medical information that identifies an
  employee is kept private
• Give each employee a notice of Belmonts legal
  duties
• Formalize a privacy policy

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When may Belmont disclose PHI?

• Treatment to a health care provider for an
  employee
• Payment assisting with claims (between provider
  and insurance carrier)
• Operations administrative purposes
• Eligibility determination
• Plan enrollment/removal
• Benefits coordination

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Employee rights

• Employees may
• Inspect and copy their medical info
• Request alternate communication about medical
  info (email, at work, at home)
• Have a right to accounting of disclosures other
  than payment or operations
• Designate a personal representative who can
  access their PHI (in writing)
• File a written complaint without penalty

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Written Authorization . . .

• Without written authorization, HR will not be
  able to discuss claims issues with the employees
  spouse
• Or a parent about their non-minor child (a child
  no longer a minor as defined by state law
  regarding PHI)

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How does this apply to you?

• You might accidentally view or access PHI by
• Banner access
• Your administrative duties
• Proximity to someones desk or you may overhear
  something
• If you are fixing someones computer
  hardware/software

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What should I do if this happens?

• Carve out your tongue
• Gouge out your eyes
• OR . . .
• Forget what you have seen
• Make sure not to share it
• Youre a professional and thats the cost of
  doing business in your job

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Stricter Safeguards

• Some jobs require frequent contact with PHI
• Lock your door when you have PHI visible and you
  have to leave your office briefly
• Have private area for discussing PHI
• Shred PHI items when no longer needed
• Put away PHI items at the end of the day
• Lock your desk and file cabinets containing PHI
• Keep phone conversations about PHI private

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Points to remember . . .

• Be wary of office gossip and chitchat
• OK to say employee out on sick leave, but do not
  discuss specific medical condition
• Example Dont Clara wont be in her office
  today because its being re-carpeted and she says
  shes allergic to glue.
• Example DO Clara has a medical condition, so
  were letting her work the phones today instead
  of working in her office.
• When in doubt, dont use email

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Penalties are stiff!

• Knowingly obtaining PHI and wrongfully disclosing
• 50,000 maximum and one-year prison term
• Using PHI for commercial or personal gain
• 250,000 maximum and ten-year prison term

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Confirmation

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