TL;DR
HIPAA: The Health Insurance Portability and Accountability Act — federal law protecting patient health information privacy and establishing standards for electronic health transactions.
HIPAA
Definition
The Health Insurance Portability and Accountability Act — federal law protecting patient health information privacy and establishing standards for electronic health transactions.
Overview
HIPAA was enacted in 1996 and amended by the HITECH Act (2009) and Omnibus Rule (2013). It establishes national standards for protecting individually identifiable health information (PHI).
The Privacy Rule governs use and disclosure of PHI. The Security Rule establishes safeguards for electronic PHI (ePHI). Both are heavily tested on certification exams.
Protected Health Information
PHI includes any individually identifiable health information relating to past, present, or future health, healthcare provision, or payment. It encompasses 18 specific identifiers including names, dates, phone numbers, SSNs, and medical record numbers.
The minimum necessary standard requires limiting PHI access, use, and disclosure to the minimum needed for the intended purpose.
Patient Rights Under HIPAA
- Right to access and obtain copies of health records
- Right to request amendments to health records
- Right to an accounting of disclosures
- Right to request restrictions on uses and disclosures
- Right to request confidential communications
- Right to receive a Notice of Privacy Practices
- Right to file a complaint
Violations and Penalties
HIPAA violations are tiered by culpability. Tier 1 (lack of knowledge): $100–$50,000 per violation. Tier 4 (willful neglect not corrected): $50,000 per violation, maximum $1.5 million per year.
Common violations include unauthorized record access (snooping), improper PHI disposal, lost unencrypted devices, unauthorized disclosures, and posting patient information on social media.
Why It Matters
HIPAA is tested on MA, PTCB, CNA, and EMT exams. You must understand protected health information (PHI), minimum necessary standard, patient rights, and penalties for violations.
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