Protecting Healthcare Fraud And Abuse - 1509 Words

Title II of HIPAA covers two main areas: preventing healthcare fraud and abuse, and a broad series of rules under the framework of administrative simplification. The first area is not of significant interest to most healthcare workers. It defines numerous offenses relating to healthcare, and authorizes several programs to attempt to find and control fraud and abuse. Nurses should be aware of the proper procedures for reporting fraud and abuse at their facility. The second portion of Title II—administrative simplification—however, contains five separate rules, most of which have already had a significant impact on virtually everyone working in American health care, including all those working in any way with health information concerning†¦show more content†¦The Final Rule now requires Business Associates to enter into business associate agreements with subcontractors who will receive, create, or transmit PHI on their behalf. The Final Rule also broadens the def inition of Business Associate to include, in addition to those entities that would qualify as business associates under the preexisting regulations, the following entities: A Health Information Organization, E-prescribing Gateway, or other person that provides data transmission services with respect to protected health information to a covered entity that requires routine access to such protected health information. A person who offers a personal health record to one or more individuals on behalf of a covered entity. ( KRYSTAL CAROL 2017) Privacy Rule First is the privacy rule, which is meant to guard the confidentiality of all protected health information. This is defined as any information that includes the patient’s name or other identifiers, such as a birth date or medical record number. Protected health information can be data that is written, spoken, or in electronic form. The privacy rule came about because many healthcare workers have been far too willing to talk casually about their patients without thinking how this violates their confidentiality, The Final Rule modifies the Privacy Rule to extend direct liability for disclosures of PHI by business associates. However, the rule does not subjectShow MoreRelatedMedicare Fraud Essay988 Words   |  4 Pagesand the Department of Justice work to reduce healthcare fraud and investigate dishonest providers and suppliers. The Health Care Fraud Prevention and Enforcement Action Team recouped almost 3 billion in fraud, this year alone. Also, aggressive strategies exist t o eliminate Medicare prescription fraud. Patients abusing or selling painkillers received by visiting several doctors and obtaining multiple prescriptions costs Medicare millions annually. 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A program through HITECH was developed for the Department of Health and Human Services to provide and institute plans to increase health care quality, safety, and efficiency through the improvement of health information technology (HIT), including electronic health records and private and secure electronic health information exchange. During the