HIPAA COMPLIANCE - PowerPoint PPT Presentation

Loading...

PPT – HIPAA COMPLIANCE PowerPoint presentation | free to download - id: 1b6ccc-ZDc1Z



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

HIPAA COMPLIANCE

Description:

... or depositing checks, processing credit card transactions, and similar conduct ... Business Associate Agreement must include description of services and require ... – PowerPoint PPT presentation

Number of Views:149
Avg rating:3.0/5.0
Slides: 16
Provided by: sbb61
Learn more at: http://www.ehcca.com
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: HIPAA COMPLIANCE


1
HIPAA COMPLIANCE
Financing Medical A/R What Does HIPAA
Require? Deborah W. Larios Miller
Martin, LLP Atlanta Chattanooga
Nashville www.millermartin.com

2
HIPAA Cash Flow Concerns
  • Provider may not be prepared to submit compliant
    electronic transactions
  • Payors may not be prepared to process compliant
    electronic transactions
  • Paper claims will take forever to process

Miller Martin, LLP Atlanta Chattanooga
Nashville
3
If you extend credit
  • Conduct due diligencewill provider be able to
    comply with HIPAA?
  • Take security interest in A/Rhow will you
    collect upon default?

Miller Martin, LLP Atlanta Chattanooga
Nashville
4
Security Interest
  • Gives lender the right to the proceeds ()
  • But does not authorize provider to disclose PHI
    in order for lender to bill and collect the
    secured A/R

Miller Martin, LLP Atlanta Chattanooga
Nashville
5
Arent banks exempt?
  • Section 1179 exempts financial institutions when
    using PHI for consumer initiated services
  • This includes cashing or depositing checks,
    processing credit card transactions, and similar
    conduct
  • Doesnt include disclosures for collection of
    secured A/R

Miller Martin, LLP Atlanta Chattanooga
Nashville
6
Disclosing PHI for Payment
  • Provider may disclose PHI to
  • Purchasers who will be covered entities
  • Payors
  • Business associates
  • Sale of PHI for other purposes could result in
    fines of up to 250,000 plus 10 years in prison

Miller Martin, LLP Atlanta Chattanooga
Nashville
7
Is Bank a Purchaser?
  • Will it be a covered entity such as a
    clearinghouse?
  • If so, bank would be subject to HIPAA

Miller Martin, LLP Atlanta Chattanooga
Nashville
8
Is Bank a Payor?
  • Is the loan considered payment for health
    services?
  • If so, bank may be considered a health plan
  • Could become a covered entity
  • Could be subject to state insurance regulations

Miller Martin, LLP Atlanta Chattanooga
Nashville
9
Is Bank a Business Associate?
  • Bank must perform a service for the providersuch
    as collecting A/R on providers behalf
  • The bank can still retain the right to keep all
    collected A/R

Miller Martin, LLP Atlanta Chattanooga
Nashville
10
Medicare A/R
  • Special measures required when collecting
    secured Medicare A/R
  • Medicare reassignment rules require
  • Payment made in providers name
  • Deposit in bank that is not providing financing
  • Provider has sole control of account and can
    revoke transfer instructions

Miller Martin, LLP Atlanta Chattanooga
Nashville
11

Collection Accounts
  • Set up one account for collection of A/R from
    sources other than Medicare or Medicaidunder
    Banks control
  • Set up second account (in different bank) subject
    to providers orderssweep on a daily basis
  • Obtain court order if provider revokes sweep order

Miller Martin, LLP Atlanta Chattanooga
Nashville
12

Other Issues
  • If Bank takes over billing function, claims must
    comply with HIPAA
  • Not a true sale if provider becomes
    insolvent, the secured A/R is subject to
    bankruptcy rules

Miller Martin, LLP Atlanta Chattanooga
Nashville
13

Business Associate Agreement
  • Business Associate Agreement must include
    description of services and require that business
    associate will
  • Not use of disclose PHI except as allowed by
    contract or law
  • Allow patients to exercise privacy rights,
    including access, amendment, and accountings of
    disclosures
  • Require agents and subcontractors to comply with
    same standards

Miller Martin, LLP Atlanta Chattanooga
Nashville
14

Business Associate Agreement (continued)
  • Report improper uses and disclosures of PHI
  • Safeguard the integrity, availability, and
    confidentiality of PHI
  • Allow inspections by DHHS
  • Allow termination upon material breach, and
    return or destroy all PHIif not feasible, must
    continue to abide by applicable terms of
    agreement.

Miller Martin, LLP Atlanta Chattanooga
Nashville
15
Questions?
Deborah W. Larios Phone 615.744.8473 E-mail
dlarios_at_millermartin.com www.millermartin.com
Miller Martin, LLP Atlanta Chattanooga
Nashville
About PowerShow.com