Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Unit:Privacy, Confidentiality, and Security
Lecture:HIPAA Privacy Rule
Slide content:HIPAA Privacy Rule Applies to covered entities (CEs)any entity that bills electronically Health care providers Clinicians, hospitals, clinics, etc. Health plans HMOs, insurance companies, etc. Healthcare clearinghouses Billing services Business associates Patient must authorize any disclosure, with the exception of treatment, payment, or operations (TPO); does not preclude health care providers from sharing data for patient care, a common misunderstanding (Houser, Houser, & Shewchuk , 2007) 6
Slide notes:Those who work in a health care setting in the United States are probably familiar with the HIPAA Privacy Rule. Patients receiving care in the United States also are exposed to the HIPAA Privacy Rule. The HIPAA Privacy Rule applies to covered entities, which are essentially any entities that electronically bill or are involved in the billing process for patient care services. One category of covered entities is health care providers, such as clinicians, hospitals, and clinics. Another category is health plans, such as health maintenance organizations (HMOs), insurance companies, and others, including business associates. This rule also applies to health care clearinghouses that deal with sensitive health information usually concerning billing services. A key point about HIPAA that leads to a lot of misconceptions is that the HIPAA Privacy Rule doesnt require patient authorization to disclose information for treatment, payments, or operations, sometimes called TPO [tee-pee-oh]. Probably the biggest misconception is that when a patient is transferred from one institution to another, the referring institution would be in violation of the HIPAA Privacy Rule by sending the patients information to the second institution. Not true! When a patient is transferred, its within the legal rights of everyone involved in the patients health care to disclose information to each other for the care of the patient. 6