The Key Elements of a Managed Care Contract and the Role HIPAA Plays in the Health Care Industry
Disclaimer.The materials on this page are intended for informational and educational purposes. No individuals should use the information, resources or tools contained herein to self-diagnosis or self-treat any health-related condition. The content of the website is not meant to be a substitute for advice provided by a doctor or other qualified health care professional. The company will not be held responsible for any negative consequences arising from the use of information posted on this site.
Documents can be shared with a simple click and access granted with credentials. Society can no longer dictate, in many cases, who or what has access to Personal Identifiable Information (PII).This especially affects healthcare provider entities, which up until the late 1990s and early 2000s kept most records in paper format.
Within HHS, the Office for Civil Rights (OCR) has responsibility for enforcing the Privacy and Security Rules with voluntary compliance activities and civil money penalties. Prior to HIPAA, no generally accepted set of security standards or general requirements for protecting health information existed in the health care industry. At the same time, new technologies were evolving, and the health care industry began to move away from paper processes and rely more heavily on the use of electronic information systems to pay claims, answer eligibility questions, provide health information and conduct a host of other administrative and clinically based functions.
Ethnic and racial minorities showed the greatest concern among the respondents. Moreover, the survey showed that many consumers were unfamiliar with the HIPAA privacy protections. Only 59 percent of respondents recalled receiving a HIPAA privacy notice, and only 27 percent believed they had more rights than they had before receiving the notice (Forrester Research, 2005). One out of eight respondents also admitted to engaging in behaviors intended to protect their privacy, even at the expense of risking dangerous health effects. These behaviors included lying to their doctors about symptoms or behaviors, refusing to provide information or providing inaccurate information, paying out of pocket for care that is covered by insurance, and avoiding care altogether (Forrester Research, 2005).
If the current criteria for waiver of authorization are to be retained, a clear and reasonable definition of impracticability from HHS, along with specific case examples of what should or should not be considered impracticable or of minimal risk, could reduce variability and overly conservative interpretations among IRBs and Privacy Boards.
Flannery J, Tokley J. AMA poll shows patients are concerned about the privacy and security of their medical records. Australian Medical Association; 2005.
Forrester Research. National survey: Confidentiality of medical records. 1999.
IOM (Institute of Medicine). Protecting data privacy in health services research. Washington, DC: National Academy Press; 2000.