0318 The Health Insurance Portability and Accountability Act (HIPAA)

 

The Department for Children and Families, as a single covered entity under HIPAA, understands that information we collect about our consumers and their health is personal.  Keeping the health information of consumers private is one of our most important responsibilities.  DCF and provider personnel will take all necessary precautions to ensure that consumer health information is kept private.  Additional information is available at:

 

http://dcf.ks.gov/Agency/Pages/HIPPA%20Overview.aspx

 

1. Purposes of HIPAA

The federal Health Insurance Portability and Accountability Act of 1996 has two key purposes: 

 

1. The "portability" portion protects health insurance coverage for workers and their families when they change or lose their jobs.
2. The "administrative simplification" portion requires national standards for electronic health care transactions, standard identifiers for providers, health plans and employers, privacy protection for health data in any medium, and security requirements for health data transmitted electronically.  It addresses, through protections, the security and privacy of patient health data.  The health data is referred to under HIPAA as "protected health information".

 

2. Protected Health Information

 

HIPAA regulations define health information as "any information whether oral or recorded in any medium that:   

 

1. is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse; and
2. relates to the past, present, or future physical or mental health or condition of an individual; the an individual if there is a reasonable basis to believe the information can be used to identify the individual.  
3. Protected health information (PHI) under HIPAA means individually identifiable health information. Identifiable health information refers not only to data that is explicitly linked to a particular individual but also includes health information with data items which reasonably could be expected to allow individual identification.HIPAA Permitted Uses and Disclosures

 

3. HIPAA Permitted Uses and Disclosures

 

1. Treatment - may use or disclose health information to provide the necessary treatment for individuals.
2. Payment Functions - may use or disclose health information about a customer to determine eligibility for plan benefits, obtain premiums, facilitate payment for the treatment and services, determine program responsibilities for benefits, and to coordinate program benefits.
3. Health Care Operations - may use information about customers to carry out necessary program related activities.
4. Required by Law - may share information required by a court order.
5. Public Health - may disclose health information to public health authorities.
6. Disclosures of Victims of Abuse, Neglect, or Domestic Violence - may disclose protected health information about an individual whom DCF reasonably believes is a victim of abuse, neglect, or domestic violence.
7. Health Oversight Activities - may disclose information to health agencies during the course of audits, investigations, inspections, and other proceedings related to oversight of the agency programs.  
8. Judicial and Administrative Proceedings - may disclose information in the course of any administrative or judicial hearing.
9. Law Enforcement - may disclose health information to a law enforcement official.
10. Coroners, Medical Examiners, and Funeral Directors - may disclose information in the course of an autopsy or death.
11. Organ and Tissue Donation - may disclose information in the course of an organ or tissue donation.
12. Public Safety - may disclose health information to an appropriate person in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.
13. National Security - may disclose health information to an appropriate person in order to prevent or lessen a serious and imminent threat to the nation's security.  
14. Correctional Institutions and Other Law Enforcement Custodial Situations -may share health information with a law enforcement official who has lawful custody of an inmate.  
15. Workers Compensation - may disclose health information to an appropriate person in the event of an on-the-job injury.
16. Appointment Reminders - may use and disclose health information to contact a customer with appointment reminders for treatment and/or services.