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Health plan organizations Health plans include HMOs, PPOs, Medicaid, Medicare, and other individuals or medical groups that pay the cost of medical care for their insured.
Health care clearinghouses Health care clearinghouses include individuals or companies which are paid to process individuals’ personal health information (PHI).
Authorization generally means giving permission to have one’s PHI distributed to third parties, other than the original medical facility providing treatment.
To be a legitimate authorization, there must be a written document, signed by the patient, giving the named medical facility permission to use specific PHI for matters other than medical treatment, payment, or surgeries.
Several days later, Dave called Susan’s physician’s office, identified himself as her husband, and asked about Susan’s test results.The Health Insurance Portability and Accountability Act (HIPAA) is a set of complex federal rules and regulations that govern how medical institutions and their business associates treat your private health information, known as “PHI.” Penalties for HIPAA violations can be substantial, ranging from fines to criminal prosecution and imprisonment. The two most important HIPAA sections addressing violations are Federal Public Law Sections 104-1.Claims of HIPAA violations are investigated by the Office of Civil Rights (OCR), a division of the U. Under HIPAA Law Section 104-191, “General Penalty for Failure to Comply with Requirements and Standards,” the U. Department of Labor can impose fines beginning at 0 on an individual for each day the violation continues, up to a maximum of ,000 per year.This includes billing service companies, health information systems, transaction facilitators, and other entities that handle PHI.Health care providers Health care providers include any person or organization that charges patients for providing treatment.