Question

1. What is HIPAA?

A. When was it passed?

2. What led to it?
3. What are the key provisions of it?
4. How does it relate to Medicare/Medicaid?

Answer 1

HIPAA

HIPAA stands for Health Insurance Probabilityand Accountability Act. It is a health insurance plan which provides healthinsurance coverage to millions of American workers and their family persons. It maintains the ethical standard for healthcare information which reduces quality care fraud and insurance abuse. It includes electronic billing process and protects all healthcare information with due privacy.

1. Passing year

It was passed in 1996.

Key provisions

Key provisions of HIPAA are as follows:

• Hospitals and healthcare organizations must update their agreements to comply with the privacy regulation policies of HIPAA
• Healthcare organizations can only disclose the information if existing regulations permit this
• Information can only be released for organ procurement organizations, banks, and transportation organizations if it is required
• Hospitals do not require consents of patients for organ procurement organizations, donation, transplant or maintaining records
• Organ procurement organizations do not need to be involved in any business agreements with hospitals

Relation with Medicare/Medicaid

HIPAA is strongly connected with Medicare and Medicaid through Medicare Medicaid coordination office. Goals set to coordinate Medicare/Medicaid with HIPAA are as follows:

• Full access benefits for dual eligible individuals who are entitled under the Medicare/Medicaid program
• Improvement in quality healthcare for long-term services for eligible individuals
• Elimination of regulatory conflicts associated with Medicare and Medicaid programs
• Improvement in care continuity
• Elimination of cost shifting between Medicare/Medicaid program and other healthcare providers
• Improvement if performance of quality healthcare providers