Question

Review (within the last year) health-related policy (not the Affordable Care Act). on the medicare or Medicaid acts or pharmacy acts, review one of those related to health care policy and review,

Introduce this policy in your paper and discuss the following:

How the governmental policy process informs the development, implementation, and assessment of policy within the realm of health care.

The impact of your chosen policy on health care consumers, organizations, and systems. The impact of your chosen policy on health care providers.

Answer 1

The Health Insurance Portability and Accountability Act (HIPAA)

It is a federal law required for the creation of national standards to protect sensitive patient health information from being disclosed without the patient's consent or knowledge.The U.S department of Health and Human services issued the HIPAA privacy rule to implement the requirements of HIPAA.

This act provides health information with transactions and these transactions includes  claims,benefits eligibility inquiries, referral authorization request and other transactions.

HEALTH PLANS

Entities that provide or pay the cost of medical care. Health plans include health, dental, vision, and prescription drug insurers; health maintenance organizations (HMOs); Medicare, Medicaid, Medicare+Choice, and Medicare supplement insurers; and long-term care insurers (excluding nursing home fixed-indemnity policies). Health plans also include employer-sponsored group health plans, government- and church-sponsored health plans, and multi-employer health plans.

The mentioned points explains how this policy informs the development of implementation and assessment of policies.

The exceptions are,

• Exception: A group health plan with fewer than 50 participants that is administered solely by the employer that established and maintains the plan is not a covered entity.
• Disclosure to the individual (if the information is required for access or accounting of disclosures, the entity MUST disclose to the individual)
• Treatment, payment, and healthcare operations
• Opportunity to agree or object to the disclosure of PHI (Informal permission may be obtained by asking the individual outright, or by circumstances that clearly give the individual the opportunity to agree, acquiesce, or object)
• Incident to an otherwise permitted use and disclosure
• Public interest and benefit activities—The Privacy Rule permits use and disclosure of protected health information, without an individual’s authorization or permission,for 12 national priority purposes.

1. When required by law
2. Public health activities
3. Victims of abuse or neglect or domestic violence
4. Health oversight activities
5. Judicial and administrative proceedings
6. Law enforcement
7. Functions (such as identification) concerning deceased persons
8. Cadaveric organ, eye, or tissue donation
9. Research, under certain conditions
10. To prevent or lessen a serious threat to health or safety
11. Essential government functions
12. Workers compensation
13. Limited dataset for research, public health, or healthcare operations.