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ATI > HIPAA > Flashcards

HIPAA Flashcards

1
Q

HIPAA

A

FEDERAL LAW
PRIVACY RULE OF THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996
INTRODUCED 2003

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2
Q

DISCLOSURE

A

REVELATION OR DIVULGENCE OF INFO

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3
Q

HEALTH INFORMATION

A

ANY INFO IN ANY FORM OR MEDIUM CREATED OR RECEIVED BY A HCP, PLAN, PUBLIC AUTHORITY, EMPLOYER, INSURER, SCHOOL, OR CLEARINGHOUSE THAT RELATES TO ANY TIME… PHYSICAL, MENTAL CONDITION, PROVISION OF HEALTH CARE , OR PAYMENT FOR THE PROVISION OF HC

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4
Q

PROTECTED HEALTH INFO

A

INDIVIDUALLY IDENTIFIABLE HEALTH INFO TRANSMITTED BY, MAINTAINED IN ANY ELECTRONIC OR OTHER MEDIUM. EXCLUDES INFO IN EDUCATION RECORD, EMPLOYMENT RECORD HELD BY A COVERED ENTITY, AND REGARDING SOMEONE DECEASED MORE THAN 50 YEARS

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5
Q

PRIVACY RULE

A

INTRODUCED TO PROMOTE USE OF STANDARD METHODS OF MAINTAINING PRIVACY OF PHI AMONG HC AGENCIES

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6
Q

COVERED ENTITY

A

HEALTH PLAN
HEALTH CARE CLEARINGHOUSE
HEALTH CARE PROVIDER
THAT TRANSMITS PHI IN ELECTRONIC FORM

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7
Q

IF BREACH OF INFO OCCURS OR IS SUSPECTED, THE ENTITY MUST

A

COMPLETE A BREACH NOTIFICATION FORM THAT IS DIRECTED TO THE SECRETARY OF THE DEPT OF HHS

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8
Q

INDIVIDUALLY IDENTIFIABLE HEALTH INFO

A

DEMOGRAPHIC INFO CREATED OR RECEIVED BY A COVERED ENTITY THAT IDENTIFIES AN INDIVIDUAL OR OFFERS REASONABLE BASIS FOR ID AND RELATES TO ANY TIME INCLUDING FUTURE PHYSICAL OR MENTAL HEALTH CONDITION, PROVISION OF HEALTH CARE, OR PAYMENT OF HEALTHCARE

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9
Q

PRIVACY RULE COVERS WHAT INFO

A

MEDICAL RECORDS AND OTHER INDIVIDUALLY IDENTIFIABLE HEALTH INFO

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10
Q

HOW DO PSYCHOTHERAPY NOTES DIFFER FROM OTHER HEALTH RECORDS

A

HELD TO HIGHER STANDARD OF PROTECTION
NOT PART OF MEDICAL RECORD
NEVER INTENDED TO BE SHARED WITH ANYONE ELSE

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11
Q

HIPAA ENABLES CLIENTS TO FIND OUT WHAT

A

HOW THEIR INFO MAY BE USED AND HOW IT HAS BEEN DISCLOSED

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12
Q

PROVIDERS AND HEALTH PLANS ARE REQUIRED TO GIVE CLIENTS WHAT

A

NOTICE OF PRIVACY PRACTICES

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13
Q

PROVIDERS AND HEALTH PLANS GENERALLY CANNOT CONDITION Tx BASED ON WHAT

A

A CLIENT’S AGREEMENT TO DISCLOSE HEALTH INFO FOR NONROUTINE USES

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14
Q

WHEN CAN CLIENT INFO BE SHARED

A

FOR THE PURPOSE OF Tx, PAYMENT, AND OPERATIONS (PTO)

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15
Q

WRITTEN AUTHORIZATION

A

DETAILED DOCUMENT, SIGNED BY A PATIENT, THAT GIVES A COVERED ENTITY PERMISSION TO USE/DISCLOSE PHI FOR A SPECIFIC PURPOSE NOT ALLOWED UNDER HIPAA OR DISCLOSE TO A THIRD PARTY

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16
Q

CLIENTS MUST BE ABLE TO WHAT

A

EXAMINE, OBTAIN A COPY, REQUEST CORRECTIONS TO THEIR HEALTH CARE RECORDS

17
Q

WHAT DOES THE PRIVACY RULE INCLUDE

A

STANDARDS FOR THE USE AND DISCLOSURE OF PHI BY COVERED ENTITIES

18
Q

USES/DISCLOSURES NOT REQUIRING AUTHORIZATION FROM THE INDIVIDUAL

A

PUBLIC HEALTH PURPOSES
COMPLIANCE OVERSIGHT
REASONABLE CONCERN FOR ABUSE, NEGLECT, DOMESTIC VIOLENCE

19
Q

WHAT LAWS MUST PROVIDERS FOLLOW

A

STATE, FEDERAL OR OTHER LAWS THAT ARE MORE RESTRICTIVE THAN HIPAA
HIPAA IS THE MINIMUM

20
Q

WHEN CAN PHI BE DISCLOSED TO COURTS

A

WHEN COURT ORDER HAS BEEN ISSUED IN ACCORDANCE WITH PROCEDURES SPECIFIED BY FEDERAL REGULATIONS. COURT MUST FIND GOOD CAUSE AND MUST BE LIMITED TO ESSENTIAL INFO FOR COURT PURPOSE

21
Q

IF AN AGENCY RECEIVES A REQUEST FOR PHI THAT IS NOT PERMITTED WHAT MUST THEY DO

A

REFUSE TO MAKE DISCLOSURE AND DO IT IN A MANNER THAT DOES NOT REVEAL THAT THE INDIVIDUAL HAS EVER BEEN DIAGNOSED OR TREATMENT

22
Q

WHEN CAN PHI BE DISCLOSED

A
  1. CLIENT COMMITED OR THREATENED TO COMMIT A CRIME ON PREMISES OR AGAINST PERSONELL
  2. RESEARCH PURPOSES
  3. GOVERNMENT AGENCY FUNDS OR REGULATES AND REQUESTS ACCESS- AUDITOR MUST AGREE IN WRITING TO PROTECT INFO
  4. REPORTING ABUSE/NEGLECT
23
Q

DISCLOSURE PERMITTED WITHOUT AUTHORIZATION TO OVERSIGHT AGENCIES. MUST BE FOR WHAT PURPOSES

A
  1. OVERSIGHT OF HEALTHCARE IE LICENSURE
  2. GVMT BENEFIT PROGRAMS
  3. GVMT REGULATORY PROGRAMS
  4. CIVIL RIGHTS LAWS
24
Q

OTHER SITUATIONS THAT MAY ALLOW DISCLOSURE OF PHI

A

JUDICIAL/ADMINISTRATIVE PROCEEDINGS
LAW ENFORCEMENT PURPOSES
AVERT SERIOUS THREAT TO HEALTH OR SAFETY
SPECIALIZED GVMT FUNCTIONS
CORRECTIONAL INSTITUTIONS
WORKERS COMP
CADAVERIC ORGAN, EYE, TISSUE DONATION

25
Q

RELEASING PHI FOR RESEARCH

A

MAY USE LIMITED DATA SETS, INFORMED CONSENT

26
Q

LIMITED DATA SET

A

PHI THAT EXCLUDES DIRECT IDENTIFIERS OF THE INDIVIDUAL OR OF RELATIVES, EMPLOYERS, HOUSEHOLD MEMBERS

27
Q

INFORMED CONSENT

A

VOLUNTARY AUTHORIZATION WHO HAS BEEN ADVISED AND UNDERSTANDS RISKS, IS FREE OF COERCION, FOR PARTICIPATION IN A STUDY, IMMUNIZATION PROGRAM, Tx REGIMEN, OR INVASIVE PROCEDURE

28
Q

ELECTRONIC DATA INTERCHANGE

A

TRANSFER OF ROUTINE INFO OR TRANSACTIONS FROM ONE COMPUTER TO ANOTHER IN A STANDARD FORMAT USING STANDARD COMMUNICATION PROTOCOLS

29
Q

MEDICARE DIAGNOSIS RELATED GROUP (DRG) PROSPECTIVE PAYMENT SYSTEM

A

PAYS HOSPITALS A PREDETERMINED AMOUNT BASED ON CONDITIONS AND EXPECTED RESOURCE USE. THE COMPENSATION IS A FIXED AMOUNT

30
Q

COVERED ENTITIES MUST ESTABLISH ADMIN SAFEGUARDS RELATED TO CODING AND BILLING INCLUDING

A
  1. CHAIN OF TRUST AGREEMENTS WITH THIRD PARTY VENDORS
  2. DOCUMENTED POLICIES/PROCEDURES FOR ALL ASPECTS OF PHI
  3. CONTINGENCY PLANS
  4. INTERNAL AUDITING
  5. PERSONNEL SECURITY
  6. RISK MANAGEMENT ANALYSES AND POLICIES
  7. TERMINATION PROCEDURES
  8. TRAINING IN HANDLING OF PHI
31
Q

HOW IS ENFORCEMENT OF HIPAA DRIVEN

A

BY COMPLAINTS

32
Q

WHO INVESTIGATES COMPLAINTS AND ENSURES CONSUMERS RECEIVE THEIR RIGHTS AND PROTECTIONS

A

OCR

33
Q

PRIVACY OFFICER

A

FACILITY EMPLOYEE APPOINTED TO DEVELOP, IMPLEMENT, AND MAINTAIN PRIVACY POLICIES. ENSURES COMPLIANCE WITH HIPAA PRIVACY RULE

34
Q

WHAT IS HIPAA ALSO KNOWN AS

A

KENNEDY KASSEBAUM ACT

35
Q

5 RULES OF HIPAA

A
  1. TRANSACTIONS AND CODE SETS RULE
  2. UNIQUE IDENTIFIERS RULE
  3. SECURITY RULE
  4. PRIVACY RULE
  5. ENFORCEMENT RULE
36
Q
A

ATI (10 decks)

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