HIPAA Basics
This act, passed in 1996, stands for Health Insurance Portability and Accountability Act.
What is HIPAA?
This is any health info that can identify a person, like a name.
What is Protected Health Information (PHI)?
This is defined as unauthorized access, use, or disclosure of PHI.
What is a HIPAA breach?
The individual receiving care in the healthcare system.
What is the Patient?
This federal program provides health insurance for people 65+ or with certain disabilities, including Parts A, B, C, and D.
What is Medicare?
HIPAA is enforced by this U.S. department, abbreviated HHS.
What is the Department of Health and Human Services?
PHI includes this personal detail, such as the day you were born.
What is date of birth?
A common cause of breaches: these attacks where hackers demand payment to unlock data.
What are cyberattacks & ransomware?
Doctors, clinics, and hospitals that provide medical services.
What is the Provider?
A fixed fee you pay for a service, such as $20 for a doctor visit or $250 for the ER.
What is a co-pay (or copayment)?
One reason HIPAA was created was to combat this widespread issue in insurance claims.
What is fraud and abuse?
PHI can be stored in this form, like on paper or a computer.
What is electronic (ePHI) or paper?
Consequences of a breach include fines up to this amount per violation.
What is $50,000?
The place where medications are dispensed to patients.
What is the Pharmacy?
After meeting your deductible, this is the percentage you pay (e.g., 20%) while insurance covers the rest.
What is coinsurance?
This is one of HIPAA's primary goals: to facilitate the portability of health coverage when changing jobs.
What is facilitating portability of health coverage across employers?
HIPAA requires PHI to be kept this way, meaning only certain people can see it.
What is limited access?
To stay compliant, implement this type of access controls based on job roles.
What are role-based access controls?
The pharmaceutical manufacturers who produce medications.
What is Pharma?
This type of plan has a smaller network and requires referrals to see specialists, often with lower premiums.
What is an HMO (Health Maintenance Organization)?
HIPAA still matters today due to the rise in this type of healthcare, like virtual doctor visits.
What is telehealth & remote care?
Patients can do this with their PHI within 30 days under HIPAA.
What is access their health records?
For major breaches, this is required: notifying the public and long-term monitoring by HHS.
What is mandatory public reporting?
Insurance companies or public payers like Medicare that process claims.
What is the Payer?
The amount you pay out-of-pocket before insurance kicks in, like $1,000 in an example where medical bills total $5,000.
What is a deductible?