HIPAA
Learning Objectives 
After completion of the course, you will be able to:
  - List 5 things that the HIPAA Privacy Rule requires the average provider or health plan to do.
 
  - Describe how the HIPAA Privacy Rule protects individuals’ medical records and other personal health information.
 
  - Explain which entities are covered by the Privacy Rule by following decision trees.
 
  - Define business associate, provide several examples of business associates, and frame a business associate contract.
 
  - Discuss six permitted uses and disclosures of protected health information.
 
  - Define the HIPAA Privacy Rule’s minimum necessary standard and its application in the use and disclosure of protected health information.
Right to Access Medical Records
 
  - Explain the right of access to the protected health information afforded to patients under the HIPAA Privacy Rule.
 
  - Explain the right to amend the protected health information afforded to patients under the HIPAA Privacy Rule.
 
  - Explain the right to an accounting of disclosures of protected health information afforded to patients under the HIPAA Privacy Rule.
 
  - Discuss various situations where incidental uses and disclosures of protected health information are permitted under the Privacy Rule.
 
  - Provide examples of reasonable safeguards a covered entity must implement to limit incidental, and avoid prohibited, uses and disclosures of protected health information.
 
  - Explain how a covered entity can disclose protected health information to a public health authority and comply with the requirement to provide individuals with an accounting for disclosures.
 
  - Define marketing and distinguish between what is marketing and what is not marketing under the HIPAA Privacy Rule.
 
  - Discuss situations when an authorization is required from the patient before a provider or health plan can engage in marketing to that individual.
 
  - Distinguish between activities for treatment or health care operations versus marketing activities.
 
  - Identify two circumstances when a patient’s prior authorization is required for the use and disclosure of protected health information for marketing.
 
  - Discuss how the Privacy Rule works with respect to disclosures for workers’ compensation.
 
  - Discuss the requirement of limited data set.
 
  - Discuss the use and disclosure of limited data set to a business associate under the HIPAA Privacy Rule.
 
  - Discuss the right provided by the Privacy Rule to individuals to receive a notice of privacy practices for protected health information, and specify the content of the notice.
 
  - Identify three entities who are not required to develop a notice of privacy practices.
 
  - Identify individuals and circumstances under which these individuals can have access to protected health information of minors or other individuals.
 
  - Explain the application of HIPAA Privacy Rule in research uses and disclosures of protected health information.
 
  - Discuss the implementation of administrative simplification requirements by
    HHS.
 
 
Course Outline
1. Protecting the Privacy of Patient’s Health Information
 Overview
 Patient Protections
 Health Plans and Providers
 Outreach and Enforcement
2. Summary of the HIPAA Privacy Rule
 Introduction
 Statutory & Regulatory Background
 Who Is Covered by The Privacy Rule
 Definitions 
 Business Associates 
 What Information Is Protected 
 General Principle for Uses and Disclosures 
 Permitted Uses and Disclosures 
 Authorized Uses and Disclosures 
 Limiting Uses and Disclosures to the
Minimum Necessary
 Notice and Other Individual Rights 
 Administrative Requirements 
 Organizational Options  
 Other Provisions: Personal Representatives
and Minors’ Personal Representatives
 State Law
 Enforcement and Penalties for Noncompliance 
 Compliance Dates  
 Copies of the Rule & Related Materials  
 Incidental Uses and Disclosures 
 Minimum Necessary 
 Personal Representatives 
 Business Associates 
 Uses and Disclosures for Treatment,
Payment, and Health Care Operations 
 Marketing  
 Disclosures For Public Health Activities
 Research 
 Disclosures For Workers’ Compensation
Purposes  
 Notice of Privacy Practice For Protected
Health Information  
 Restrictions on Government Access to Health
Information 
  
3. Implementation of Administrative Simplification Requirements by HHS
  
Overview
  Implementation Plan
  Standards Adoption Process
  Public and Private Sector Input into the Standards Development Process
Implementation Schedule
Understanding CMS’s Compliance Policy
  What Is a Contingency Plan?
  Steps For Contingency Planning
  Health Plan Responsibilities
  Review Your Good Faith Efforts to Comply
4. Security Standard
 General Approach  
 Specific Requirements  
  Guidance on Compliance with HIPAA
Transactions and Code Sets After the October 16, 2003 Implementation Deadline
  
    
Enforcement Approach
Working Toward Compliance
    
  
 HIPAA Administrative Simplification
Compliance Act (ASCA) 
 Electronic Transaction Standards 
 
Code Set Standards  
  
  What Is a Code Set
What Code Sets Have Been Adopted as HIPAA Standards?   
  
5. FAQ About HIPAA
  HIPAA: In General  
  Privacy Rule: General Topics  
  Protected Health Information  
  Preemption of State Law 
  Covered Entities  
  Compliance Dates 
  Minimum Necessary
  Business Associates 
  Treatment/Payment/Health Care Operations  
  Right to Access Medical Records 
  Complaints 
  Right to an Accounting of Disclosures 
  Incidental Uses and Disclosures 
  Public Health Uses and Disclosures
  Facility Directories 
  Disclosure to Family and Friends 
  Disclosures Required by Law  
  Disclosures for Rule Enforcement 
  Disclosures for Law Enforcement
Purposes  
  Authorizations  
  Marketing Uses and Disclosures  
 Workers’ Compensation
Disclosures 
 Notice of Privacy Practices  
 Personal Reps/Parents and Minors  
 
Limited Data Set 
 
 
Research Uses and Disclosures 
 
 
Transition Provision  
  
  Appendix A: Notice of Privacy Practices
Appendix B: Sample Business Associate Contract
Appendix C: How to File a Health Information Privacy Complaint With the
Office For Civil Rights
 
 
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