Implementing Federal, State, and Local Policies in Health Care Organization

MHA 520 Module 3 (Case): Implementing Health Policy Within Healthcare Organizations
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MHA 520 Module 3 (Case): Implementing Health Policy Within Healthcare Organizations
Overview of the Policy (HIPAA Act of 1996)
Represents national standards formulated by the federal government in 1996
President Bill Clinton Signed it on August 21 (Moore & Frye, 2019)
HIPAA is the national tool that protects the access and distribution of patient information (HIPAA, 1996)
It outlines regulations for health facilities to comply
It highlights the patient’s rights
All healthcare institutions, including non-profit hospitals, must adhere to existing regulations about releasing healthcare records. Moore and Frye (2019) indicate that the Health Insurance Portability and Accountability Act of 1996 (HIPAA) is the primary policy in the United States that provides national standards by the federal government and requires all facilities to comply. The authors also indicate that President Bill Clinton Signed it on August 21 after passing all the stages in Congress. As a result, it became a national tool for protecting the patient’s health information (PHI), including its access and distribution (HIPAA, 1996). Its central objective is to outline the regulations for facilities and patients.
Overview Cont.
HIPAA prohibits PHI release without written consent by patients
Highlights situations when PHI release is acceptable in the absence of consent
Exceptional situations include:
Disasters
Court orders (HIPAA, 1996)
Treatment-related operations
Public health purposes (Moore & Frye, 2019)
Compliance is critical for avoiding consequences for the hospital
HIPAA is particular with the access and sharing of medical records. In this context, the policy prohibits any release of PHI without patients’ authorization except in key highlighted circumstances. Moore and Frye (2019) note that this regulation ensures that all healthcare providers interact with the patient information on a “need-to-know basis,” leading to confidentiality. HIPAA (1996) demonstrates exceptional situations where healthcare providers can disclose PHI without the patient’s consent. Such situations include disasters, court orders, treatment-related operations, and public health purposes (Moore & Frye, 2019). Healthcare providers must remain aware of these provisions to avoid non-compliance that can trigger diverse ramifications on the facility.
Implications for Our Non-Profit Hospital for Non-Compliance
Non-compliance exposes hospitals and employees to the following:
Criminal
Financial consequences
The severity of the penalty depends on different factors (Moore & Fyre, 2020). E.g.
Was the violation willful?
Negligent?
Failure to comply with the diverse regulations guiding the release of healthcare records exposes a healthcare facility and its affected individuals to financial and criminal ramifications. Moore and Frye (2020) reveal that the severity of the penalties depends on diverse factors, including whether the violation is willful or negligent. The authors in...