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What = is HIPAA?
3D"*"The Hea= lth Insurance Portability and Accountability Act
3D"*"Law pas= sed to ease the movement of healthcare data between providers.&= #13;
3D"*"Places new restrictions on disclosure of “protected health information” (PHI) that will impact the Universit= y of Alabama.
------=_NextPart_01C7BFC0.14D44470 Content-Location: file:///C:/48C8B227/hipaa-privacy-training_files/master03_image004.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlh/QGNAXcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAAAAAD7 AYwBgwAAAABmZmZmmX+ynrq+kLKyt8CeSt/OkNzeswECAwECAwECAwECAwECAwECAwECAwT/kMhJ q704U8G7/2Aojh1gmlqqrhPpvnB5snS9xXguz3a/6sDYCeAraoJIknFpSTo/QyJzSnhaOUPq9GqN apncZ/ZrDDvJZXPQi/apkeO27b2Oy2l0oP3+y+f4NX44bIB9gjB7hRmHQomKF4yIPI9HkS6UKZYk hJiQmiOOnRKfoKGipCKmnaghFAivsLGys7S1tgW4ubq7vL2+vh6cBLbExcavv8nKy7hQkxLH0dLI zNXWBc7Pw9PcxNffytlSE93ltODovR+u5u2w6fC5wXvu7vHx4hX17ffw4uPQ9pXrly4fO4HcCKJb Rw5hN4Xg5mlzmBDiNYMNKUazeFEiioMa/41xtIYxYEiRI5kxNHmyWEqVOz5mbHnrZTiP+mh6s5ns X06dtXj2xAkSqCyhv1ZuM3oOqbqYAJcyjeX0acyfU99V3eWzaNatXInOzIoArK4PAdIGGMC2rdu3 cOPKnXugrt27ePPq3bvXgF8DUdSmnUu4sGG2fBMrXlz3r98hgtcenkx5AOPLmBs7Diy4sufCmUMr dgz4ROTPqOOKXq2XdOfUsNuynm13M+TXsVPTpk36ttrcsHfP7u17MHDUwlkTN3H6+Ofkq13/dv4c emjbpnFTn2z9OnYAzbdz7455OXPt4kGTv2w+fHr16xdLN/7ecHzG38Gjr6/6/ujv7vHXn/9/fJmn 33QCykVgYu3tl6BsC/blmIMPIhZha39xhmCFbl2IYYbZbcihhR7eZWCAI5aIV4MipqhibRNGJuOM NNZoo1qk5ajjjjz2CGKINwYppI0+FmmkkcUNqeSSRzbpZH5LRsnkk1QiCaSUWNJY5ZY9ZumlllyG CeWXZOIo5pmlnVcmmWieqeGaXrYpZpJwSilnmHV+eeeWb+YZ5Z58XumnkoBW2eegQxZKJZ2IBqno k43++eiRh0ZK5KSUCmppjZhmqummM3ZqpZqgXipql6XeeGqPlaYq2KqsfupqWrDy2OqsAdS6I6O4 5qprjlEEK+ywxBZr7LHIJqvsssw26+z/s9BGK+201FZr7bXYZqvtttx26+234IYr7rjklmvuueim q+667Lbr7rvwxivvvPTWa++9+Oar77789uvvvwAHLPDABBds8MEIJ6zwwgw37PDDEEcs8cQUV2zx xRhnrPHGHHfs8ccghyzyyCSXbPLJKKes8sost+zyyzDHLPPMNNds880456zzzjz37PPPQAct9NBE F2300UgnrfTSTDft9NNQRy311FRXbfXVWGet9dZcd+3112CHLfbYZJdt9tlop6322my37fbbcMct 99x012333XjnrffefPft99+ABy744IQXbvjhiCeu+OKMN+7445BHLvnklFdu+eWYZ675/+acd+75 56CHLvropJdu+umop6766qy37vrrsMcu++y012777bjnrvvuvPfu++/ABy/88MQXb/zxyCev/PLM N+/889BHL/301Fdv/fXYZ6/99tx37/334Icv/vjkl2/++einr/767Lfv/vvwxy///PTXb//9+Oev //789+///wAMoAAHSMACGvCACEygAhfIwAY68IEQjKAEJ0jBClrwghjMoAY3yMEOevCDIAyhCEdI whKa8IQoTKEKV8jCFrrwhTCMoQxnSMMa2vCGOMyhDnfIwx768IdADKIQh0jEIhrxiEhMohKXyMQm OvGJUIyiFKdIxSpa8YpYzKIWt8jFLv968YtgDKMYx0jGMprxjGhMoxrXyMY2uvGNcIyjHOdIxzra 8Y54zKMe98jHPvrxj4AMpCAHSchCGvKQiEykIhfJyEY68pGQjKQkJ0nJSlrykpjMpCY3yclOevKT oAylKEdJylKa8pSoTKUqV8nKVrrylbCMpSxnScta2vKWuMylLnfJy1768pfADKYwh0nMYhrzmMhM pjKXycxmOvOZ0IymNKdJzWpa85rYzKY2t8nNbnrzm+AMpzjHSc5ymvOc6EynOtfJzna6853wjKc8 50nPetrznvjMpz73yc9++vOfAA2oQAdK0IIa9KAITahCF8rQhjr0oRCNqEQnStGKWvSPohjNqEY3 ytGOevSjID2jn/akCjeYgVdxupMwtnBSWWWJpNpgaRhuhSWYxhQMLTXWSFV60yWoAaUv5WlP0zBT l9ZUqFGRKRdoaiekJhWnRdVpnmz6VJ/m9EBwompVibpUozZVTiXtwU+B+tU2rRSqXZVqnaiKhrGS ak1abetVdwrWoRbBrW9lk1PlGtUoRAAAOw== ------=_NextPart_01C7BFC0.14D44470 Content-Location: file:///C:/48C8B227/hipaa-privacy-training_files/image005.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhEgASAHcAACH/C01TT0ZGSUNFOS4wGAAAAAxtc09QTVNPRkZJQ0U5LjAIEUxdiAAh/wtN U09GRklDRTkuMBgAAAAMY21QUEpDbXAwNzEyAAAAAaYOEpAAIfkEAQAABAAsAAAAABIAEgCDz5pl M2aZaGiYz86ZwMDAAAAAAAAAAAAAAQIDAQIDAQIDAQIDAQIDAQIDAQIDAQIDA0JIuhQxg0nlKryz VXcx21YHLWAoRlp5jim4RqV5xtwL3Dgu7Dyf/70g4acL7hTEm/E4TC4FC6dRQpxOgL0MQwmdJAAA Ow== ------=_NextPart_01C7BFC0.14D44470 Content-Location: file:///C:/48C8B227/hipaa-privacy-training_files/slide0003.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" HIPAA PRIVACY TRAINING
UA is a “hybrid entity&#= 8221; – having several health care components under HIPAA.
3D"*"HIPAA applies to University of Alabama (UA) “Health Care Components”: University <= /span>Medical Center, Brewer-Porch, the Speech & Hearing Clinic, Nursing Clinic and UA’s Group Health Insurance and other Health = plans.
•   It also applies to administ= rative departments, like t= he Legal Office and Auditing, Privacy Officer, etc. supporting any of these Health Care Components.
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UA Will Have One Common Approach to Compliance
3D"*"One appr= oach to HIPAA compliance; each health care component will hav= e its own policies and procedures to ensure the privacy of Protected Health Information.
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HIPAA establishes rules for privacy, = security, and electronic transmission of data.  This training focuses on privacy.
3D"*"For UA’s health care providers, the Privacy = Rule are:
3D"*"Sets boundaries on the way providers use and release protected health information (PHI);
3D"*"Establishes safeguards that we must achieve to protect the privacy of PHI;
3D"*"Provides for adverse consequences including fines and jail sentences for failure to comply.
3D"*"
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What is “Protected Health Information” (PHI)?=
3D"*"PHI is any information, including demographic information, that is TRANSMITTED or MAINTAINED in any MEDIUM (electronic, paper, or spoken word) = that is created or received by a health care provi= der, health plan, or health care clearinghouse that rel= ates to or describes the past, present or future physic= al or mental health or condition of an individual; the <= /span>provision of health care to an individual; or futu= re payment for the provision of healthcare to the individual.
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Some records are not PHI:
3D"=Student records that fall under the Family = Educational Rights and Privacy Act (FERPA).
3D"== Medical records, exempt from FERPA, of students 18 or over or attending UA and that are made or maintained by a health care provider and used only to treat the student and disclosed only to individuals providing the treatment.
3D"*"The University’s Employment Records.<= /span>
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Possible Criminal Penalties for the Employee:
3D"=Wrongfully accessing or disclosing PHI: Fines up to $50,000 and up to 1 year in prison.
3D"=Obtaining PHI under false pretenses: Fines = up to $100,000 and up to 5 years in prison.
3D"=Wrongfully using PHI for a commercial = activity: Fines up to $250,000 and up to 10 years in prison.
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Possible Civil Penalties for the University:
3D"*"Up to $100 per violation. <= /span>
3D"*"Each nam= e in a data set can be a violation.
3D"*"Not to exceed $25,000 per year.
3D"*"AND = 211; civil monetary damages may be available to patients who win state tort claims, such as breach of privacy.
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General Rule for Use & Disclosure of PHI<= /div>
3D"*"A cover= ed entity can always use and disclose PHI for any purpose if it g= ets the person’s written authorization.
3D"*"HIPAA requires certain components to be in the authorization = in order for it to be valid.
3D"*"There are many exceptions to the requirement for authorization.
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Except= ions:
3D"*"No authorization is needed if for Treatment, Payment and Healthcare Operations (TPO).
3D"*"PHI (except psychotherapy notes) may be used/disclosed for the covered entity’s own TPO. 
3D"*"PHI may be disclosed to other covered entities or a health care providers for the payment activities of the entity that receives the information, such as an ambulance = company.
3D"*"PHI may be disclosed to another covered entity or health care provider for its health care operations, under limited circumstances.
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No authorization is required to disclose to Business Associates
3D"*"PHI may= be disclosed to a Business Associate if the Covered Entity has= executed a Business Associate Agreement with the Business Associate.
3D"*"Each UA Health Care Provider  = identifies who its Business Associates are.
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No authorization is needed to disclose PHI:
3D"*"When required (not permitted) = by law;
3D"*"To Publ= ic Health/Legal Authorities charged with preventing and control= ling disease, disability or injury;
3D"*"To FDA = to ensure quality, safety, or effectiveness of FDA-regulated products;
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And:
3D"*"To perso= ns who may have been exposed to communicable disease or may be at risk of contracting or spreading a disease;
3D"*"To enti= ties charged with overseeing victims of abuse, neglect or domest= ic violence, consistent with reporting obligations;
3D"*"To a hea= lth oversight agency for activities authorized by law (government licensing or accreditation agencies)
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And
3D"=In response to a Court order;
3D"*"In response to a subpoena that meets certain requirements (always check with the Legal <= /span>= Office);
3D"*"Law enforcement officials seeking to identify a suspect, witness, or victim of a crime;
3D"*"Coroners/medical examiners/funeral directors to identify a deceased person or determine a cause of death;
3D"*"Organizations handling organ, eye or tissue donation;
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And:
3D"== To prevent/lessen a serious and imminent threat to patients or others health and safety;= 3;
3D"== To military command authorities and federal officials for intelligence and national security <= /span>= activities;
3D"*"To comply with workers compensation laws;
3D"*"Facility directories, if asked by name.
3D"=Individuals involved in patient’s care or payment.
3D"*"<= span style=3D'font-size:88%'>Persons involved in disaster relief.=
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HIPAA requires UA’s Health Care Providers to:
3D"*"Provide notice to individuals of information practices.
3D"*"Authoriza= tion Forms
<= span style=3D'mso-special-format:bullet;mso-bullet-image:"image005\.gif";font-s= ize: 80%'>3D"*"Control access
3D"*"Account f= or use and disclosures
3D"*"Manage complaints
<= span style=3D'visibility:hidden'>3D"=
3D"*"Have a privacy officer
<= span style=3D'mso-special-format:bullet;mso-bullet-image:"image005\.gif";font-s= ize: 80%'>3D"*"Conduct training
<= span style=3D'mso-special-format:bullet;mso-bullet-image:"image005\.gif";font-s= ize: 80%'>3D"*"Provide sanctions
3D"*"Develop Business Associate Agreements
3D"*"Have poli= cies and procedures
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Under HIPPA, patients have the right to:
3D"*"Receive Notice of Health Information Practices.
3D"=Authorize use of their data.
3D"=Request access to their data.
3D"*"Request an accounting of the uses and disclosures of their data.
3D"*"Request amendment and corrections to their data.
3D"=Request restrictions on use of data.
3D"=File a complaint.
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UA Must Meet the Minimum Necessary Standard=
3D"*"Providers should disclose or use only the minimum necessary amount of PHI in order to do their jobs.
<= span style=3D'font-size:88%'>3D"=Minimum necessary does not apply to:
•  1. disclosures used for treatment;
•  2. = to the individual who is the subject of the       = 3;
•        disclosure;
•  3. = when a valid HIPAA authorization is signed;
•  4. = Uses and disclosures required by law;
•  5. Disclosures to HHS.
•
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Incidental Disclosures are Permitted if:
3D"*"They cannot be reasonably prevented;
3D"*"Are limited in nature;
3D"*"Are a by-product of otherwise permitted use; and
3D"*"The Cov= ered Entity has established “reasonable safeguards”= to ensure only necessary information is disclosed.
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Incidental Uses and Disclosures Include:
3D"*"Waiting room sign-in sheets = 3;
3D"*"Patient charts at bedside =
3D"*"Physici= an conversations with patients in semi-private room
3D"*"Physicia= ns conferring at nurse’s stations.
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What HIPAA did not Change:
3D"*"Family a= nd friends can still pick up prescriptions for sick people. <= /span>
3D"*"Physici= ans and Nurses do not have to whisper.
3D"*"State l= aws still govern the disclosure of minor’s health information to parents. (a minor is under the age of 19 in Alabama)
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UA’s Covered Health Care Providers are Required to Have and Use:
•   1. Notice of Privacy Practices
•   2. Authorization Forms =
•   3. Accounting for Disclosures
•   4. Business Associate Agreements
•
•UA has developed template forms and policies for health care components.
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1. No= tice of Privacy Practices
3D"*"Notice of patient’s rights with respect to PHI = and UA’s privacy practices.
3D"*"Providers must make a good faith effort to obtain the patient’s written acknowledgement at the time of receipt of the Notice of Privacy Practices, except in emergency circumstances.
3D"*"Each patient must receive a Notice of Privacy practices no later than the date of first service = delivery.
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The Notice of Privacy Practices:
3D"*"Must li= st each type of disclosure that may be made by the covered entity a= nd distinguish between those that are made pursuant to law and those that= are not.
•
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 2. The Authorization Form
3D"=An Authorization Form is required for the use and disclosure of PHI for business-related = purposes other than Treatment, Payment, and Operations and other than the permitted exceptions.
3D"=Authorizations are always required to disclose psychotherapy notes in order to give psychotherapy notes stronger protections.
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Psych= otherapy Notes
3D"=Must be kept separately from the patient’s <= /span>medical record.
3D"=Consists of the “process notes” that t= he therapist makes about counseling sessions.
3D"=Does not include summary information used <= /span>for treatment such as symptoms; summary notes; diagnosis, and medications.
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Authorization Required for Marketing
3D"*"UA is prohibited from using or disclosing PHI for marketing purposes without the patient’s= = express authorization.
3D"*"Prohibited from selling patient lists to third parties.
3D"*"CAN talk with patients about our treatment options, and have common health care communication about wellness, prescription = refill reminders, therapies, and appointment notifications without an authorization.
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Autho= rization for Marketing:
3D"*"Must disclose if UA is receiving benefits or payment from any third party receiving the patient’s information.
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3. Accounting For Disclosures
3D"*"Individuals have the right to receive an accounting of disclosures of PHI made by UA, except for:
•   = ;  -Disclosures made to carry out Treatment,       
•      Payment, = and health care Operations;
•   = ;  -PHI provided to the patient about them;
•   = ;  -PHI disclosed to family members or friends   
•      involved = in a patient’s care;
•   = ;  -Disclosures made pursuant to authorization.
•UA has designed forms for tracking disclosures.
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4. Business Associate Agreements
3D"*"Business Associates perform specific tasks involving the use/disclosure of PHI on our behalf, such as billing, legal services, and accreditation.
3D"*"UA must have a written agreement with Business Associates (BA) specifying the purpose for which PHI will be used or disclosed.
3D"*"UA must be able to account for these disclosures to BAs and the BA must be able to track disclosures.
3D"*"UA has a BAA Template.  If we ar= e the BA, use our BA form, or= one similar.
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HIPAA Will Put New Requirements on Research:
3D"*"If you work for a Health Care Provider under HIPAA, do not release PHI for research = unless:
•       - T= he patient has signed a valid HIPAA &nb= sp;
•         authorization, or
•       - T= he IRB at UA has approved a waiver of   
•         authorization; or
•       - T= he IRB agrees that an exception applies.
•Separate training on HIPAA & Research is availab= le through the Privacy Office.
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Security Standards – Gene= ral Rules
3D"=HIPAA security standards will ensure the confidentiality, integrity, and availability of PH= I created, received, maintained, or transmitted electronically (ePHI – Electronic Protected = Health Information) by and with all facilities.= 3;
3D"=Protect against any reasonably anticipated = threats or hazards to the security or integrity or such information
•
3D"=
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Security Standards (cont’d)
3D"=Protect against any reasonably anticipated = uses or disclosures of such information that are not permitted
3D"*"Ensure compliance by the workforce
3D"*"Each covered entity must conduct an accurate and thorough assessment of the potential risk and vulnerabilities to the confidentiality, integrity, and availability of ePHI.
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Securi= ty Standards (cont’d)
3D"*"The security regulations are organized into 3 sections known as safeguards:
lAdministrative =
lPhysical
lTechnical
lRequired
lAddressable<= /div>
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Admin= istrative Safeguards
3D"*"<= span style=3D'font-size:88%'>Security management process
lMust develop policies and procedures to prevent, detect security violations
3D"*"Workforce security
lEnsure appropr= iate access for all faculty, residents, students, and staff
lPrevent unnecessary access
lUMC will have keyless entry in the near future to allow access for only authorized individuals.
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Administrative Safeguards = (cont’d)
3D"*"Information access management
lAuthorization = of access for workforce and support personnel only
3D"*"<= span style=3D'font-size:88%'>Security awareness and training =
lWorkforce trai= ning for all faculty, residents, students, and staff
3D"*"Security incident procedures
lAddress security incidents as the need arises =
l
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Administrative Safeguards (cont’d)
3D"*"<= span style=3D'font-size:88%'>Contingency Plan/Disaster Recovery Plan
lResponse to an emergency that damages systems that contain ePHI (for example: fire, vandalism, system failure, and natural disasters) = Evaluation
lPeriodically evaluate all physical and technological access
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Physi= cal Safeguards
3D"*"Facility access controls
lLimit physical access to electronic systems and the facility in which they are housed.
3D"*"<= span style=3D'font-size:88%'>Workstations use
lSpecify proper functions
3D"*"Workstation security
lPhysical safeguards
3D"*"<= span style=3D'font-size:88%'>Device and media controls
lReceipt and re= moval of hardware and electronic media that contain ePHI into and out of the facility and movement within the facility.
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