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HIPAA

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. In HIPAA language health plans - Health care clearinghouses - and all health care providers that transmit HIPAA standard transactions electronically are called covered entities. Hospitals - nursing homes - hospices - pharmacies - physician practices
Covered entities
a contract that comes about from the actions of the parties rather than words
treatment - payment - & healthcare operations
A written set of questions requiring written answers from a plaintiff or defendant under oath

2. Releasing patient information
generally only patient can auth release of own medical record - there are a few exceptions
a contract that comes about from the actions of the parties rather than words
Any information that would identify a patient (name - add - tele - DOB - SSN - email - med. rec. number - etc)
allows patients to give directions to health care providers about treatment choices in circumstances in which the patient may no longer be able to provide that direction. There are two types: Living Will and Durable Power of Attorney

3. A written document detailing a health care provider's privacy practices.
although medical records are confidential - there are times when they can be released w/o a patient consent.
Ethical
Type of consent in which a patient who is unable to give consent is given treatment under the legal assumption that he or she would want treatment.
Notice of Privacy Practices (NPP)

4. Protected health information from which certain patient identifiers have been removed
U.S. goverment
Limited data set
Privacy
a contract that comes about from the actions of the parties rather than words

5. Transmission of information between two parties fro financial or administrative activities.
U.S. Department of Health and Human Services (HHS; established national standards for HIPAA) - Centers for Medicare and Medicaid Services (CMS; enforce insurance portability and transaction/code set requirements) - Office for Civil Rights (OCR; enfor
Transaction
must be reported to authorities by law
parent of a minor - legal guardian - Agent (patient selected on behalf in h/c power of attorney)

6. Clearinghouse
a service company that recieves electronic or paper claims from the provider - checks and prepares them for processing - and transmits them in HIPAA-complaint format to the correct carriers
same legal standards apply to all patient records whether on paper or computer
Encryption
Covered transactions

7. PII
need to know
Invasion of Privacy Publishing
Patient Identifiable Information
Verification

8. Fax machines
h/c workers --qualified people of organizations(perf. data processinf or transcript) -certain gov. auth. (pub health activities) -appropriate auth(protect vic. of abuse) -law enforcement officials or judicial orders
should only be used when no other - more secure mode of transmission is available
Patient Identifiable Information
Electronic Protected Health Information

9. Subpoenas
A court order requiring someone to appear in court on a certain date time and reason. A medical record could be subpoenaed.
parent of a minor - legal guardian - Agent (patient selected on behalf in h/c power of attorney)
allows patients to give directions to health care providers about treatment choices in circumstances in which the patient may no longer be able to provide that direction. There are two types: Living Will and Durable Power of Attorney
Covered transactions

10. Medical records can be released w/o consent to...
parent of a minor - legal guardian - Agent (patient selected on behalf in h/c power of attorney)
the philosophical study of moral values and rules - conducts
h/c workers --qualified people of organizations(perf. data processinf or transcript) -certain gov. auth. (pub health activities) -appropriate auth(protect vic. of abuse) -law enforcement officials or judicial orders
De-Identified Information

11. Common law
judge made law from decisions of a court - interpretation of constitution and statuatory law - often known as precedents
Notice of Privacy Practices
Insurance portability - administrative simplification - privacy and security
patient discharges doctor with letter - doctor formally withdraws from patient with a certified letter or patient no longer needs treatment

12. Fax Machines and HIPAA
should only be used when no other - more secure mode of transmission is available
in order to maintain patient confidentiality - fax machines must be kept in areas not accessible to patients.
Rule
Individually Identifiable Health Information

13. Federal law protects patient records dealing with...
must be reported to authorities by law
substance abuse treatment
Minimum necessary
patient discharges doctor with letter - doctor formally withdraws from patient with a certified letter or patient no longer needs treatment

14. Reportable diseases...
a service company that recieves electronic or paper claims from the provider - checks and prepares them for processing - and transmits them in HIPAA-complaint format to the correct carriers
patient discharges doctor with letter - doctor formally withdraws from patient with a certified letter or patient no longer needs treatment
must be reported to authorities by law
it must have an accompanying disclaimer stating the fax information cannot be shared with any other party w/o patient's written consent

15. Misfeasance
U.S. goverment
Malfeasance
state laws setting time limit for bringing a lawsuit
improper performance of an otherwise lawful act. civil

16. Name - address - date of birth - phone/fax numbers - social security number - medical record number - and photographs - nursing and physician notes - billing and other treatment records used during a patient's visit in a hospital or office.
patient discharges doctor with letter - doctor formally withdraws from patient with a certified letter or patient no longer needs treatment
U.S. goverment
Examples of PHI
malpractice

17. Civil law
concerns noncriminal disputes between private parties
Notice of Privacy Practices (NPP)
Electronic transmission
Health Information

18. Medical records used for health care research

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19. Includes records maintained by or for a covered entity.
Tort
Designated record set
State preemption
Limited data set

20. Unlawful act done without permission.
Malfeasance
Privacy
in order to maintain patient confidentiality - fax machines must be kept in areas not accessible to patients.
Psychotherapy notes - information for legal proceedings - information exempted from disclosure under CLIA

21. Under some circumstances ...
Duty; duty of care - Derelict; breach of the duty of care - Direct cause; legally recognizable injury occurs as a result of breach of care - Damage; wrongful activity must have been the cause
a minor - rather than the parent - must sign the release of patient information
substance abuse treatment
treatment - payment - & healthcare operations

22. HIPAA
Notice of Privacy Practices (NPP)
Health Insurance Portability and Accountability Act of 1996 (passed by congress because of portability problems - also to protect PHI)
the philosophical study of moral values and rules - conducts
failure to act with the standard of care that a reasonable person would exercise under the same circumstances

23. Statutory
concerned with mostly with h/c providers. It addresses fraud and abuse - administrative simplification and medical liability
The body of laws made by states is their own statutory laws
state law that protects healthcare professionals from liability when they provide emergency assistance/services within their scope of training
De-Identified Information

24. DII
regular - in a secure location
substance abuse treatment
in order to maintain patient confidentiality - fax machines must be kept in areas not accessible to patients.
De-Identified Information

25. Conforming to proper professional behavior
Invasion of Privacy Publishing
Ethical
treatment - payment - & healthcare operations
A court order requiring someone to appear in court on a certain date time and reason. A medical record could be subpoenaed.

26. Titile II of HIPAA
law concerned with public wrongs against society
concerned with mostly with h/c providers. It addresses fraud and abuse - administrative simplification and medical liability
Insurance portability - administrative simplification - privacy and security
Verification

27. Advanced directives
allows patients to give directions to health care providers about treatment choices in circumstances in which the patient may no longer be able to provide that direction. There are two types: Living Will and Durable Power of Attorney
Portability
Notice of Privacy Practices
in order to maintain patient confidentiality - fax machines must be kept in areas not accessible to patients.

28. 4d's of negligence
Health Information
Duty; duty of care - Derelict; breach of the duty of care - Direct cause; legally recognizable injury occurs as a result of breach of care - Damage; wrongful activity must have been the cause
state laws setting time limit for bringing a lawsuit
The body of laws made by states is their own statutory laws

29. Doctor release of patient
patient discharges doctor with letter - doctor formally withdraws from patient with a certified letter or patient no longer needs treatment
Any information that would identify a patient (name - add - tele - DOB - SSN - email - med. rec. number - etc)
Every office should have one! - responsible for making surethat thise office is HIPAA compliant - privacy officer should be.. an effective communicator with ability to answer questions about sespected HIPPA violations and complaints
a service company that recieves electronic or paper claims from the provider - checks and prepares them for processing - and transmits them in HIPAA-complaint format to the correct carriers

30. Implied contract
Individually Identifiable Health Information
false and malicious writing about another
judge made law from decisions of a court - interpretation of constitution and statuatory law - often known as precedents
a contract that comes about from the actions of the parties rather than words

31. HI
in order to maintain patient confidentiality - fax machines must be kept in areas not accessible to patients.
Code sets
Health Information
also called biomedical ethics - the moral dilemmas and issues of advanced medicine and medical research

32. NPP
Notice of Privacy Practices
may be disclosed to public health agencies - patient identifiers are removed so it's covered by HIPAA
the philosophical study of moral values and rules - conducts
Every office should have one! - responsible for making surethat thise office is HIPAA compliant - privacy officer should be.. an effective communicator with ability to answer questions about sespected HIPPA violations and complaints

33. Disabilities act

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34. Confidentiality

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35. See & Copy their health records - update health records - obtain a list of the institution's disclosures - other than for payment & healthcare operations - request a restriction on a certain uses or disclosures - choose how to receive their health in
Privacy
Patient rights under HIPAA
individuals such as cleaning staff and consultants who work in the office. These individuals do not need access to patient info but may come in contact while completing their duties
Insurance portability - administrative simplification - privacy and security

36. 5P's of ethical power
Designated record set
purpose - pride - patience - persistence - perspective
parent of a minor - legal guardian - Agent (patient selected on behalf in h/c power of attorney)
Type of consent in which a patient who is unable to give consent is given treatment under the legal assumption that he or she would want treatment.

37. Professional Negligence
Portability
addresses portability of insurance coverage when employees change or lose their jobs
malpractice
Privacy

38. Title I of HIPAA
Portability
addresses portability of insurance coverage when employees change or lose their jobs
h/c workers --qualified people of organizations(perf. data processinf or transcript) -certain gov. auth. (pub health activities) -appropriate auth(protect vic. of abuse) -law enforcement officials or judicial orders
Treatment - payment and health care operations (TPO)

39. Verify the identification of anyone requesting patient information.
should only be used when no other - more secure mode of transmission is available
Verification
Covered entities
the philosophical study of moral values and rules - conducts

40. Key entities
regular - in a secure location
the philosophical study of moral values and rules - conducts
Covered transactions
U.S. Department of Health and Human Services (HHS; established national standards for HIPAA) - Centers for Medicare and Medicaid Services (CMS; enforce insurance portability and transaction/code set requirements) - Office for Civil Rights (OCR; enfor

41. Negligence
concerns noncriminal disputes between private parties
failure to act with the standard of care that a reasonable person would exercise under the same circumstances
purpose - pride - patience - persistence - perspective
Minimum necessary

42. Business Associate Agreements applies to...
Psychotherapy notes - information for legal proceedings - information exempted from disclosure under CLIA
individuals such as cleaning staff and consultants who work in the office. These individuals do not need access to patient info but may come in contact while completing their duties
Insurance portability - administrative simplification - privacy and security
should only be used when no other - more secure mode of transmission is available

43. What information do patients NOT have access to?
Encryption
purpose - pride - patience - persistence - perspective
substance abuse treatment
Psychotherapy notes - information for legal proceedings - information exempted from disclosure under CLIA

44. Patient records are _____________ so not all staff will have access.
patient discharges doctor with letter - doctor formally withdraws from patient with a certified letter or patient no longer needs treatment
need to know
law concerned with public wrongs against society
have a unique password and it should be changed frequently

45. All persons who will have access are required to...
Ethical
Prohibits discrimination preventing indiviualds with physical or mental disabilities or chronic illness - from accessing public services & accomodations. Employers requires 'reasonable accommodation' be provided so they can perform duties.
A written set of questions requiring written answers from a plaintiff or defendant under oath
have a unique password and it should be changed frequently

46. The limited amount of patient information to be disclosed - depending on circumstances.
in order to maintain patient confidentiality - fax machines must be kept in areas not accessible to patients.
Every office should have one! - responsible for making surethat thise office is HIPAA compliant - privacy officer should be.. an effective communicator with ability to answer questions about sespected HIPPA violations and complaints
Minimum necessary
substance abuse treatment

47. interrogatory
concerns noncriminal disputes between private parties
should only be used when no other - more secure mode of transmission is available
located in a secured and private space
A written set of questions requiring written answers from a plaintiff or defendant under oath

48. De-Identified Information
A court order requiring someone to appear in court on a certain date time and reason. A medical record could be subpoenaed.
Patient Identifiable Information
Medical data from which individual identifiers have been removed; also known as a redacted or blinded record.
should only be used when no other - more secure mode of transmission is available

49. What are the 3 purposes of HIPAA?
Individually Identifiable Health Information
Insurance portability - administrative simplification - privacy and security
Electronic Protected Health Information
Ethical

50. Electronic exchanges of information between two covered-entity business partners using HIPAA mandated transaction standards.
Electronic data interchange
Covered transactions
Ethical
human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS)