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What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute
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What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute.

Dec 14, 2015

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Page 1: What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute.

What Nurses Assistants Need to Know about HIPAA

YAYA Medical Training Institute

Page 2: What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute.

Health Insurance Portability and Accountability Act (HIPAA)

• In mid 1990s Congress passed the Health Insurance Portability and Accountability Act (HIPAA) of 1996. As a step toward portability, HIPAA called for rules that would:

• Provide administrative simplification, basically by standardizing the interchange of medical data

• Protect patient confidentiality

• Protect the security of patient data

The law also provided for significant fines for violating standards (for wrongful disclosure of medical data)

Page 3: What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute.

Purpose of Module : HIPAA

• The purpose of this module is to provide the Nurse Assistants with an understanding of what they need to know about HIPAA regulations and how they affect the day-to-day decisions concerning patient care

Page 4: What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute.

Objectives of Module

• After reviewing this module, you should be able to :

• Describe the intent of the HIPAA regulation• Describe how HIPAA affects confidentiality• Describe how HIPAA affects information

transfer

Page 5: What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute.

Introduction

• Computers are being used more commonly in healthcare, and proved tremendous benefit– Speed up procedures– Ease of communication– Access to patient data– Access to lab findings

• However, there has also been a growing fear that this increasing use of computers for storing and transmitting patient information may undermine patient confidentiality

Page 6: What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute.

HIPAA

• HIPAA addresses these problems along three major avenues:

• Administrative simplification• Patient Confidentiality• Data Security

Page 7: What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute.

Administrative Simplification

• This will involve the personnel in information systems, medical records and administration.

• However, nurse assistants may be required to use new data gathering tools, new forms or programs due to the HIPAA process

• A move to standardize the coding of electronic transfer of data to insurance agencies and other payers will be implemented with the HIPAA

Page 8: What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute.

Confidentiality

• This section will affect nursing greatly– “General rule is that patient authorization is

required for any use or disclosure of protected information that is not directly related to treatment, payment or health operations”

This is to prevent unauthorized disclosures to anyone outside the agency or within the agency

Page 9: What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute.

Confidentiality in Special Settings

• Home Health – Must not forget that the nurse assistant is not a friend of the patient, but is a caregiver even though the setting is more relaxed. Be careful NOT to reveal confidential information to neighbors, family or friends

• Long Term Care – In long term care residents have gotten to know one another, there may be questions about another resident. AVOID discussing a resident’s condition with another resident.

Page 10: What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute.

Confidentiality in Special Settings

Psychiatric /Chemical Dependency Units –

The law requires much more stringent protection of privacy in these settings. It is a violation of federal law to reveal or even confirm the identity of a patient in any psychiatric setting or chemical rehab.

• Other special Circumstances– HIV– Pregnancy– Sexual Abuse– RapeThese patients are may be at risk

for breach of confidentiality. Normally parents of minors are automatically given information regarding their child’s condition, but law varies from State to State. Know your state’s law.

Page 11: What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute.

Reporting Laws and Confidentiality

• There are some exceptions to a caregiver’s obligation to keep information confidential– ThreatsPatients in psychiatric setting

sometimes make threats to harm others. DO NOT try to decide if a threat is serious. REPORT any threats to your supervisor immediately.

– Suspected Abuse

When you encounter any patient who appears to have been physically abused, you have a duty to report your suspicions. Report any suspected abuse to the nurse or call the domestic abuse hotline.

Page 12: What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute.

Other exceptions to confidentiality

Criminal Wounds

Gunshots Poisonings

Communicable Diseases and Emergency Circumstances

Deaths of an Uncertain Nature

Report to your supervisor and follow agency/state guidelines

Page 13: What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute.

How does this affect you?

• If you receive a fax, it must be placed in a secured area, face down

• DO NOT XEROX portions of the patient’s chart, MAR, Lab/diagnostic findings

• DO NOT DOWNLOAD patient information from the computer

• DO NOT TAKE any patient information home

Page 14: What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute.

Who Must Comply?

• HIPAA law defines those who must comply as: All persons involved with access to patient information and medical records. (This includes Nurse Assistants and Home Health Aides)

• Protected health information includes, but is NOT limited to:• Social Security Number• Name• Address and phone number/ Fax number• Date of birth• Diagnosis• Email address• Medical record number• Any account numbers or patient information identifying the

patient

Page 15: What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute.

Data Security

• The third major portion of HIPAA is directly related to confidentiality. This is the maintaining the security of patient data, particularly when it is transmitted outside the institution.

• Each agency will have a policy and procedure for the handling of transmission, security of computer systems and codes

Page 16: What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute.

Penalty

• Under HIPAA, civil and even criminal penalties can be imposed on organizations and individuals for wrongful disclosure or other forms of noncompliance. Wrongful disclosure is defined as either knowingly or unknowingly sharing or disclosing information without patient/resident permission.

• A facility that does not follow

these rules may:– Be responsible for civil

penalties and fines that can quickly add up to thousands of dollars.

– Be accused of criminal violations that can result in even higher fines and incarceration

– Be excluded from participation in the Medicare Reimbursement Program

Page 17: What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute.

Penalties portion of HIPAA

• Civil money penalties are $100.00 per violation, up to $25,000 per year for each requirement or prohibition violated

• Criminal penalties are up to $50,000 and one year in prison for certain offenses.– Up to $100,000 fines and up to 5 years in prison if the offenses are

committed under false pretenses

– Up to $250,00 in fines and up to 10 years in prison if the information obtain is found to be used for commercial advantage, personal gain or malicious harm

Page 18: What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute.

Conclusion

• According to HIPAA legislation, when information must be communicated, you must make sure it is for treatment or billing or other uses within the law and within the policies/procedures of your facility

So before you answer the phone when someone asks you if a certain celebrity is a patient in your hospital…think again!

You will be violating HIPPA if you do not have the patient’s permission to share that information.

Page 19: What Nurses Assistants Need to Know about HIPAA YAYA Medical Training Institute.

References

• Cichon, T. (2002) Can you pass the HHN’s HIPAA Quiz? Home Health Nurse. 20(6), 400 – 401.

• How HIPAA will change your practice.(2002) Nursing. 32(9), 54-57.• Maio, J. (2003) HIPAA and the Special status of psychotherapy notes.

Lippincott’s Case Management. 8(1), 24-29• The New HIPAA Law on Privacy and Confidentiality. (2002) Nursing

Administration Quarterly. 26(4). 40-54.• Oram, M. (2003) CEU: HIPAA Regulations Update Course # 106• What you need to know about HIPAA. CEU Course: RN.com• Wilber, K. (2003) HIPAA Security Requirements: Prepare to Comply.

Healthcare. www.medscape.com/view article/448840• Williams, T. (2002) HIPAA… one size does not necessary fit all. Home

Healthcare Nurse. 20(4). 221-224• Ziel, S. (2002) Legal checkpoints: Get on board with HIPAA privacy regulations. Nursing Management. 23(10), 28-29